Relationship of hypotension and cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.
OBJECTIVE
Changes in systemic arterial blood pressure and the degree of cerebral vasospasm were investigated in 125 patients with aneurysmal subarachnoid hemorrhage.


METHODS
Systemic arterial blood pressure was measured every 2 hours in each patient for a period of more than 2 weeks, and a fall in systemic blood pressure (FBP) was defined as a decrease of >40 mmHg of systolic blood pressure between two consecutive measurements.


RESULTS
A total of 91 FBPs occurred in 52 (41.6%) of 125 patients despite specific post-operative management to prevent hypovolemia. Five (5.5%) of the 91 FBPs occurred just before the onset of symptomatic vasospasm. Symptomatic vasospasm was observed in 36 (69.2%) of 52 patients with FBP and in 32 (43.8%) of 73 patients without FBP (p<0.01, chi-squared test). A hypodense area on computed tomographic scans in association with cerebral vasospasm was observed in 25 (48.1%) of 52 patients with FBP and in 21 (28.8%) of 73 patients without FBP (p<0.05).


CONCLUSIONS
We conclude that FBP might result from delayed cerebral vasospasm and/or brain dysfunction owing to subarachnoid hemorrhage itself.
Department of Neurosurgery, Institute of Neurological Sciences, Tottori University School of Medicine, Yonago 683-8504, Japan. stabuchi@gj8.so-net.ne.jp
Sadaharu
S
Tabuchi
Nobuo
N
Hirano
Michiharu
M
Tanabe
Masamichi
M
Kurosaki
Hisayo
H
Okamoto
Hideki
H
Kamitani
Masayuki
M
Yokota
Takashi
T
Watanabe
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D002536:Cerebral Arteries / Q000503:physiopathology; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D020301:Vasospasm, Intracranial / Q000209:etiology* / Q000503:physiopathology