From the Guidelines

Vasospasm is a common occurrence in traumatic subarachnoid hemorrhage (SAH), affecting approximately 30% of patients.

Vasospasm in SAH frequently occurs 7 to 10 days after hemorrhage, with spontaneous resolution by day 21 1.
The condition is associated with delayed cerebral ischemia, which can lead to significant morbidity and mortality, increasing by 10% to 20% after onset of clinical symptoms 1.

Despite the association between moderate to severe vasospasm and poor clinical outcome, only 50% of patients with large-vessel vasospasm develop clinical ischemic neurologic symptoms 1.
Delayed ischemia can occur in the absence of imaging findings of vasospasm, highlighting the importance of early screening and detection 1.
Transcranial Doppler (TCD) monitoring is a key component in identifying patients at high risk for vasospasm, with TCD imaging and transcranial color-coded Doppler (TCCD) showing greater sensitivity and specificity for middle cerebral artery vasospasm 1.

From the Research

Vasospasm is a significant complication in patients with traumatic subarachnoid hemorrhage (SAH), with a reported incidence of 42.1% in one study 2.
Another study found a lower incidence of vasospasm, at 8%, which may be due to the retrospective nature of the study and the infrequency of obtaining CT angiography after initial presentation 3.
The incidence of vasospasm in traumatic SAH is associated with the severity of the trauma, with higher-grade TBI patients being more likely to experience vasospasm 2, 3.

Vasospasm in traumatic SAH can occur in various arteries, including the middle cerebral artery (MCA), anterior cerebral artery (ACA), and basilar artery (BA) 2, 4.
The timing of vasospasm in traumatic SAH can vary, but it is often seen in the first and second weeks after the injury 2, 4.
Vasospasm in traumatic SAH can lead to significant neurological deficits and poor outcomes, including death 3, 4.

The severity of the trauma, as measured by the Glasgow Coma Scale (GCS) score, is a significant risk factor for vasospasm in traumatic SAH 2, 3.
The presence of subarachnoid hemorrhage on CT scan is also a risk factor for vasospasm in traumatic SAH 2, 3.
Other risk factors for vasospasm in traumatic SAH may include the location and volume of the hemorrhage, as well as the presence of other injuries or comorbidities 5.

The management of vasospasm in traumatic SAH can include medical and endovascular treatments, such as nimodipine, hypertension, and angioplasty 5.
The choice of treatment for vasospasm in traumatic SAH depends on the severity of the vasospasm, the presence of neurological deficits, and the overall clinical condition of the patient 5.
Further research is needed to determine the optimal management strategies for vasospasm in traumatic SAH and to improve outcomes for these patients 2, 3, 5.