Cerebrovascular reactivity evaluated by transcranial doppler sonography in patients after aneurysmal subarachnoid haemorrhage treated with microsurgical clipping or endovascular coiling technique.
OBJECTIVE
To examine cerebrovascular reactivity in patients after subarachnoid haemorrhage (SAH) during long-term follow-up, using Acetazolamide test and transcranial Doppler (TCD) monitoring of blood flow velocities (BFVs), to compare of CO(2) reactivity between patients after SAH treated with three different methods: surgical (clipping), endovasculary (coiling) and conservative.


METHODS
The study was performed in a group of 24 patients treated for SAH. Cerebrovascular reactivity (CVR) has been evaluated after intravenous administration of 1000 mg of Acetazolamide. Studied patients were divided into three groups: group I (n = 10) treated with clipping, group II (n = 8) treated with coiling and group III (n = 6)--patients with negative angiography treated conservatively.


RESULTS
Results of this study have shown that: (1) BFVs were normal in cerebral arteries and did not differ between right and left head sides, (2) CVR was normal in all studied patients, (3) method of aneurysm treatment as well as its localization had no influence on BFV and CVR, and (4) occurrence of vasospasm in early days after SAH did not result in permanent disturbances of CO(2) arterial reactivity.


CONCLUSIONS
BFV values in cerebral arteries were in normal range and did not differ on the left and right head sides. CVR was normal in all examinated patients. A method of the ruptured aneurysm treatment and its localization had no influence on CBFV and CRV. Vasospasm in early period after SAH did not provoke a persistent impairment of CO(2) reactivity.
Jarus-Dziedzic
Katarzyna
K
Department of Neurosurgery, Medical Research Centre, Polish Academy of Sciences, Cegłowska 80, 01-800 Warsaw, Poland. neuropan@cmdik.pan.pl
Głowacki
Mariusz
M
Warzecha
Adam
A
Jurkiewicz
Jerzy
J
Czernicki
Zbigniew
Z
Fersten
Ewa
E
D000086:Acetazolamide / Q000494:pharmacology; D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
D000086:Acetazolamide