Predictors of Vasospasm in SubArachnoid Hemorrhage
Muhammad Rizwan Husain, MD
PGY-3 Neurology Resident
These are exciting times to be a resident in neurology, where the field has considerably evolved over the last few decades. Many decades ago, neurology was thought of as only a field attributed to diagnosing neurological conditions, with very little treatment available. Over the years, through the help of cutting edge research, extensive clinical trials and the advancements in some outstanding technologies, we have been able to provide our patients with treatment modalities that ultimately have led to a timely neurological recovery. However, a lot more needs to be done to further advance our understanding and tackle the intricate complexities of the brain.
As a neurology resident, my personal interests have been in cerebrovascular diseases and critical care. A significant portion of our training exposes us to manage some of the sickest patient populations, especially those who have developed a stroke or a brain bleed. One of my major research areas has been in predicting the development of vasospasm after a subarachnoid hemorrhage (SAH). It is not uncommon to have cared for many patients in the neuro-intensive unit with a SAH who, while showing significant improvements, are found to suddenly deteriorate. The concept of vasospasm and delayed cerebral ischemia is well known and the literature has described various cell markers like neutrophils, lymphocytes in the serum to serve as predictive models. However, my colleagues and I, led by Dr. Fernando Testai, chief of the stroke division, are trying to ascertain changes that occur in the CSF that could provide an early, predictive model for risk of developing vasospasm and help guide further treatments. Our study results show that changes in cell counts in the CSF with increased neutrophils can occur as early as the very first day in patients after SAH who would later go on to develop vasospasm. This research could help us provide better care early and opens the door for further research into better understanding neuro-inflammation and potential targets to identify and build novel therapeutic agents to target vasospasm.
Muhammad Rizwan Husain, MD
PGY-3 Neurology Resident