[Time-related changes in the cerebral blood flow in subarachnoid hemorrhage due to ruptured cerebral aneurysm].
Cerebral blood flow (CBF) was determined by the 123I-IMP SPECT reference sample method in 39 patients with subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysm. They were examined according to the time lapse after onset, severity, CT findings, and prognosis. These 39 patients were admitted to our medical center within 36 hours after the onset, and SAH and ruptured aneurysm were diagnosed by CT scan and angiography, respectively. Patients with intraventricular hemorrhage, intracerebral hematoma, and other severe complications were excluded. The stage of SAH was divided into three, by designating the day of onset as day 0: day 0-4 as the acute stage, day 5-20 as the subacute stage, and day 21 and after that as the chronic stage. Acute stage surgery was conducted within 48 hours after the onset on principle. Hyperdynamic therapy and cisternal drainage were conducted in severe case of SAH. The prognosis was evaluated with Glasgow outcome scale (GOS). The average CBF was 33.39, 29.44, and 33.15 in the acute, subacute, and chronic stages, respectively. These are values lower than the reference sample value, 43.39 (ml/100 g/min). Only a small number of cases, however, revealed vasospasm by angiography conducted in the acute stage. There was a correlation between the CT severity in the acute stage and the decrease in CBF. In the group with low density area (LDA) on CT due to delayed cerebral ischemia in the subacute stage, the average CBF was 28.28 and 23.95 in the acute and subacute stages, respectively. These values were significantly lower than 35.97 and 32.45, respectively, in the group without LDA.(ABSTRACT TRUNCATED AT 250 WORDS)
Fukuda
T
T
Department of Neurosurgery, Hachiouji Medical Center.
Hasue
M
M
Ko
M
M
Hasegawa
K
K
Nakamura
T
T
Miwa
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002560:Cerebrovascular Circulation; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed