Hyperglycemia in aneurysmal subarachnoid hemorrhage: a potentially modifiable risk factor for poor outcome

Nyika D Kruyt, Geert Jan Biessels, J Hans DeVries, Merel J A Luitse, Marinus Vermeulen, Gabriel J E Rinkel, W Peter Vandertop, Yvo B Roos

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Abstract

Hyperglycemia after aneurysmal subarachnoid hemorrhage (aSAH) occurs frequently and is associated with delayed cerebral ischemia (DCI) and poor clinical outcome. In this review, we highlight the mechanisms that cause hyperglycemia after aSAH, and we discuss how hyperglycemia may contribute to poor clinical outcome in these patients. As hyperglycemia is potentially modifiable with intensive insulin therapy (IIT), we systematically reviewed the literature on IIT in aSAH patients. In these patients, IIT seems to be difficult to achieve in terms of lowering blood glucose levels substantially without an increased risk of (serious) hypoglycemia. Therefore, before initiating a large-scale randomized trial to investigate the clinical benefit of IIT, phase II studies, possibly with the help of cerebral blood glucose monitoring by microdialysis, will first have to improve this therapy in terms of both safety and adequacy.

Original languageEnglish
Pages (from-to)1577-87
Number of pages11
JournalJournal of Cerebral Blood Flow and Metabolism
Volume30
Issue number9
DOIs
Publication statusPublished - Sep 2010

Cite this

Kruyt, N. D., Biessels, G. J., DeVries, J. H., Luitse, M. J. A., Vermeulen, M., Rinkel, G. J. E., ... Roos, Y. B. (2010). Hyperglycemia in aneurysmal subarachnoid hemorrhage: a potentially modifiable risk factor for poor outcome. Journal of Cerebral Blood Flow and Metabolism, 30(9), 1577-87. https://doi.org/10.1038/jcbfm.2010.102