Functional methods for evaluation the occurrence of delayed ischemic deficit in patients with subarachnoid hemorrhage.
Detection of early circulatory and electrophysiologic changes due to vasospasm (VS) after subarachnoid hemorrhage (SAH) is a necessity for in-time and adequate therapeutic management. The aim of the present case report is to describe and demonstrate the results of transcranial Doppler (TCD) monitoring and brainstem auditory evoked potentials (BAEPs) examination, which indicate the development of combined circulatory insufficiency in two vascular systems. On the 14th day after SAH, TCD showed accelerated velocities in the territory of middle cerebral artery (MCA) and basilar artery (BA). BAEPs, after ipsilateral stimulation, performed on the same day verified changes of potentials on the left side with abnormal I/V amplitude ratio. These results were suggestive of brainstem dysfunction. The CT examination of the next day revealed infarction in the posterior parietal borderline zone of the left hemisphere. The patient had clinical signs of sensory aphasia, which resolved completely after one-week treatment with nimodipine.
Haralanov
L
L
Department of Neurology, Medical University of Sofia, "Queen Joanna" Hospital, 8 Bialo more Street, 1528 Sofia, Bulgaria. EurJMedRes@t-online.de
Klissurski
M
M
Stamenova
P
P
D000328:Adult; D001041:Aphasia, Wernicke / Q000209:etiology; D001488:Basilar Artery / Q000503:physiopathology; D001921:Brain / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006801:Humans; D020768:Middle Cerebral Artery / Q000503:physiopathology; D009553:Nimodipine / Q000627:therapeutic use; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial; D014665:Vasodilator Agents / Q000627:therapeutic use; D014711:Vertebral Artery / Q000503:physiopathology
D014665:Vasodilator Agents; D009553:Nimodipine