Background
Delayed cerebral ischemia (DCI) is defined as the occurrence of focal neurology impairment or a decrease in the level of consciousness (2 points in Glasgow coma scale) for at least one hour, in the context of a subarachnoid aneurysm hemorrhage (SAH). The symptoms should not be explained by other causes such as fever, seizure or hydrocephalus. If these neurologic symptoms are attributed to sonographic or angiographic arterial spasm, it is characterized as symptomatic vasospasm.
 

Method
We present the clinic characteristics of patients from Hospital São Paulo (São Paulo- Brazil) with DCI after subarachnoid aneurysmatic hemorrhage who also had a sonographic arterial spasm. These patients were submitted to either hypertension induction or endovenous vasodilator (milrinone) treatment.

Results
During one year, 11 patients of our service had documented DCI after SAH. The majority of our sample was female (59%) and an average age of 46 years old. The average Hunt-Hess scale was 2,6; the World Federation of Neurosurgical Societies SAH grading scale was 2; the modified Fisher scale was 2,3. Ninety percent of our patients were submitted to surgical clipping in a mean time of 8 days after the hemorrhage. The preferred therapy to treat DCI was endovenous Milrinone, according to Montreal's Protocol. 

Conclusion
Aneurysmatic SAH is a devastating condition and the exact pathophysiology of DCI remains uncertain. Our sample describes our experience in treating DCI and the most prominent characteristics of the patients with this complication. A greater knowledge of this entity is essential to improve SAH's morbidity rates.

CHARACTERISTICS OF PATIENTS WITH DELAYED CEREBRAL ISCHEMIA AFTER SUBARACHNOID ANEURYSMATIC HEMORRHAGE