[Transluminal angioplasty in the treatment of vasospasm. Value of transcranial Doppler in the diagnosis and follow-up].
Vasospasm (V.S.) transluminal angiographic treatment (T.L.A.) is recommended in case of symptomatic V.S. before or after surgery. V.S. diagnosis and follow up after T.L.A. rely on clinical and transcranial doppler (T.C.D.) data. Before T.L.A. angiography (A degrees) demonstrates V.S. degree and location. T.L.A. technic is described. The authors report 14 cases of T.L.A. (7 before and 7 after surgery). Before surgery in 4 cases patients exhibited ischemic symptoms from V.S.: 2 died (one from reanimation problems the other from a new hemorrhage). After surgery of 7 patients one died from artery rupture, one from extra-neurologic complication. T.C.D. capacity to follow up V.S. is emphasized. As soon as T.L.A. is performed the mean cerebral blood flow (C.B.F.) decreases (< 100 cm/s) and does not increase anymore. At the level of non dilated arterial segments V.S. may increase after T.L.A.: it is then recommended to dilate all the spastic arteries, as far as it is possible. After T.L.A. C.B.F. may decrease in arteries far from the dilated ones probably because arterial supplies are no more necessary.
Bracard
S
S
Service de Neuroradiologie, Hôpital Saint-Julien, Nancy.
Ducrocq
X
X
Picard
L
L
Marchal
J C
JC
Auque
J
J
D000800:Angioplasty, Balloon; D002560:Cerebrovascular Circulation; D004453:Echoencephalography; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011184:Postoperative Period
Angioplastie transluminale dans le traitement du vasospasme. Intérêt du Doppler transcrânien dans le diagnostic et le suivi.