[Angiographic vasospasm and regional cerebral blood flow in the cases of ruptured aneurysm --Correlation between vasospasm in the middle cerebral artery and delayed ischemic hemiparesis (author's transl)].
It is well known that the vasospasm following rupture of aneurysm causes ischemic neurological symptoms. However, there are a few literatures which refer to the relationship between the severity of angiographic vasospasm and regional cerebral blood flow (rCBF) and ischemic neurological symptoms. To elucidate this problem, 41 patients with ruptured aneurysm were analysed by means of repeated cerebral angiography and rCBF study, and the following results were obtained. 1. Mean rCBF was reduced to its lowest level in the second week of hemorrhage and at this stage, the values of mean rCBF were well correlated with the severity of the angiographic vasospasm and with the development of delayed ischemic neurological symptoms. 2. The morphological feature of the angiographic vasospasm was a smooth narrowing of the vessels, and the delayed ischemic hemiparesis occurred when both M-1 and M-2 portions of the middle cerebral artery are narrowed more than half comparing the calibers as seen within 3 days of hemorrhage. 3. The average of mean rCBF in 15 patients with symptomatic spasm was 27.0 +/- 5.5 ml/100 g/min. and that in 11 patients with asymptomatic spasm was 40.8 +/- 8.8 ml/100 g/min. As a conclusion, the prognosis of the patients with angiographic vasospasm may be predicted through the value of rCBF and the severity of angiographic vasospasm in the second week of hemorrhage.
D000328:Adult; D000368:Aged; D001810:Blood Volume; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D005260:Female; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D002546:Ischemic Attack, Transient / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous