Critical increase of blood flow velocities after subarachnoid haemorrhage: vasospasm versus hyperaemia.
Thirty cases of subarachnoid haemorrhage (SAH), who underwent early aneurysm clipping, were studied to clarify the significance of a critical increase of blood flow velocities in correlation to neurological disability and cerebral blood flow. Three different groups of patients could be distinguished: 57% (17) of the cases showed increased TCD-values at the affected side corresponding to secondary neurological deficits (Vasospasm-group). The CBF-results pointed out a side difference according to the flow acceleration. In 7 patients (23%) we detected a similar side difference in blood flow velocity, but no secondary deficit appeared. The corresponding CBF-measurements showed risen values with no side difference (Hyperaemia-group). The third group of patients (20% i.e.6 cases) developed neurological deficits and corresponding side difference in CBF-measurements, but the transcranial Doppler sonography could not detect a significant side difference and even showed normal values (Blind-TCD-group). Critical increased blood flow velocities after SAH without secondary neurological deficits does not indicate vasospasm but hyperaemia.
Meixensberger
J
J
Department for Neurosurgery, University of Würzburg.
Hamelbeck
B
B
Dings
J
J
Ernemann
U
U
Roosen
K
K
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D017585:Ultrasonography, Doppler, Transcranial