Assessing Platelet Counts as Predictors of Vasospasm and Discharge Outcomes in Aneurysmal Subarachnoid Hemorrhage

Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) carries a 21.9% 30-day case fatality rate, largely due to complications from cerebral vasospasm (CVS), which can lead to delayed cerebral ischemia (DCI). Despite extensive research, the best predictive biomarkers for vasospasm remain unclear. This study evaluates whether variations in platelet count predict vasospasm and patient outcomes in aSAH. Methods: A retrospective cohort study included 297 aSAH patients from the Henry Ford Health System electronic medical records. Inclusion criteria required an aSAH diagnosis, hospital admission within 24–48 hours of symptom onset, transcranial Doppler (TCD) data, daily platelet count, and modified Rankin scale (mRS) scores. Platelet counts were categorized as thrombocytosis (>450,000), normal (150,000–450,000), or thrombocytopenia ( Results: Vasospasm occurred in 62% of thrombocytotic patients (p = 0.4), 57% of thrombocytopenic patients (p = 0.8), and 57% of those with normal platelet counts. Middle cerebral artery (MCA) flow velocities exceeded 120 cm/sec across all groups. No significant association was observed between platelet count and vasospasm incidence. The average mRS was 3 (SD = 2) across all groups, indicating no difference in discharge outcomes. Conclusion: Platelet count does not predict vasospasm or patient outcomes in aSAH. Future research should focus on alternative biomarkers to improve the management and prognosis of aSAH.