Acetazolamide Challenge With Perfusion in the Prediction of Cerebral Vasospasm
Subarachnoid Hemorrhage, Aneurysmal, Vasospasm, Cerebral
About this trial
This is an interventional diagnostic trial for Subarachnoid Hemorrhage, Aneurysmal focused on measuring acetazolamide challenge, cerebral vasospasm, aneurysmal subarachnoid hemorrhage
Eligibility Criteria
Inclusion Criteria:
- Patients with aneurysmal subarachnoid hemorrhage presenting to our institution within 24 hours of symptom onset
- Adults, 18 years of age or older
- Women of childbearing potential must not be pregnant (negative urine pregnancy test)
Exclusion Criteria:
- Contraindication to acetazolamide (i.e. sulfonamide allergy, renal or liver failure)
- Contraindication to contrast media (Allergy or abnormal serum Cr and/or GFR based on current UW guidelines for IV contrast)
- Renal insufficiency, history of renal failure or renal transplant
- Hunt and Hess grade 1 and 5 (Attached protocol provides details on the grading scale. Grade 1 have lowest yield for vasospasm and Grade 5 are by definition critically ill and unstable patients)
- Critically ill patients who are unstable and who cannot undergo scans within the proposed timeline i.e. within 24 hours of the onset of their symptoms.
Sites / Locations
- University of Wisconsin
Arms of the Study
Arm 1
Experimental
Acetazolamide Challenge
Participants entered into the study as a cohort, will because of their participation, undergo only two additional digital subtraction angiogram (DSA) imaging acquisitions. These will be done in conjunction with their standard diagnostic DSA evaluation and consist of two CBCTPs, one before and one after administration of 1 g acetazolamide through a peripheral IV line. Each CBCTP will require administration of 75-100 mL iodinated contrast medium also through an intravenous line. Neither of these imaging studies will be used for clinical decision making, but would be processed and evaluated at later date for a formal analysis of the results. Following completion of diagnostic imaging subjects will receive the usual standard of care for treatment of their ruptured aneurysm i.e. endovascular embolization or open surgical clipping.