[Diagnosis of vasospasm: comparison between arteriography and transcranial Doppler. A series of 112 comparative tests].
56 consecutive patients with ruptured aneurysm (An) were studied. The An localisation were: anterior communicating artery (ACoA) 26 cases, internal carotid artery (I.C.A.) 13 cases, Middle cerebral artery (M.C.A.) 11 cases, Pericallosal artery (P.C.A.) 4 cases, anterior cerebral artery (A.C.A.) 2 cases. Nimodipine infusion was started as soon as the diagnostic was established. Transcranial Doppler (T.C.D.) and angiography (A degrees) were performed at the arrival and 10 to 12 days after surgery. Surgery was performed in the 72 first hours after S.A.H. in 79% of the cases. 112 comparisons A degrees-T.C.D. were available. An A degrees vasospasm (V.S.) was assessed if the reduction of calibre was 25% or more, on T.C.D. V.S. was assessed if mean cerebral flow (M.C.F.) was equal to or more than 130 cm/sec. There were 15 cases of A degrees V.S. in 14 patients: 2 cases before surgery, 1 case before and after surgery in the same patient and 11 cases after surgery. D.T.C. exhibited 11 cases of V.S. at the level of M.C.A.; there were 11 true positive, 0 false positive, 97 true negative and 4 false negative. The diagnosis of V.S. was always correct with T.C.D. when A degrees V.S. was present at the level of M.C.A., it was not made when A degrees V.S. was restricted to the initial part of A.C.A. (A1) uni or bilaterally: 3/6 cases of ACoA. An rupture or to I.C.A.: 1/4 case of I.C.A. An. rupture.(ABSTRACT TRUNCATED AT 250 WORDS)
Langlois
O
O
Département de Neurochirurgie, Centre Hospitalier et Universitaire, Hôpital Charles-Nicolle, Rouen.
Rabehenoina
C
C
Proust
F
F
Freger
P
P
Tadie
M
M
Creissard
P
P
D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery; D002533:Cerebral Angiography; D004453:Echoencephalography; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000209:etiology; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000150:complications
Diagnostic du vasospasme: comparison artériographie-Doppler transcrânien. Une série de 112 examens comparatifs.