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Review summarizes the role of microthrombi and hypercoagulability in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage, suggesting significant implications for patient outcomes.
Despite increasing knowledge over the last several decades of the factors contributing to delayed cerebral ischemia (DCI), it remains a significant cause of morbidity after aneurysmal subarachnoid hemorrhage (aSAH). The hypercoagulable state induced by aneurysm rupture is critical to most proposed mechanisms of DCI either through its direct contribution to microthrombi formation, or through the indirect effects of the products of coagulation on vasospasm, and inflammation. In this review we summarize clinical evidence of hypercoagulability after aSAH as well as both the clinical and pre-clinical evidence of its role in DCI, highlighting the developing role that microthrombi and NETosis are thought to play.
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Wroe et al. (2026) studied this question.
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