title: Placing intracerebral probes to optimise detection of delayed cerebral ischemia and allow for the prediction of patient outcome in aneurysmal subarachnoid haemorrhage.
abstract: Cerebral microdialysis could be useful to detect delayed cerebral ischemia in aneurysmal subarachnoid haemorrhage patients. The optimal location of the probes, however, remains controversial. Here, we determined the vascular territories with the highest infarct risk in relation to aneurysm location to define probe implantation guidelines. These guidelines were retrospectively validated by studying the likelihood of probe to fall in a secondary infarct area, and by analysing their influence to predict patient outcome. The vascular territories with highest risk of infarction were the anterior cerebral arteries for anterior communicating artery aneurysms and the ipsilateral middle cerebral artery for internal carotid artery, posterior communicating artery and middle cerebral artery aneurysms. When cerebral microdialysis probes had been implanted in these territories, 79% were located within an infarcted area versus 54% when they were implanted in other territories. Delayed cerebral ischemia was detected only when the probe was located within a brain area later affected by secondary infarction, which could justify the use of implantation guidelines. Moreover, individual patient outcomes could be predicted when probes were placed in the brain territories as suggested by this study. Thus, a precise probe placement algorithm can improve delayed cerebral ischemia detection sensitivity and allow for a better prediction concerning patient outcome.
authors: 1 Department of Biochemistry and Molecular Genetics, Dupuytren University Hospital, Limoges, France.|2 TIGER Team, Lyon Neuroscience Research Center, CNRS, UMR 5292, INSERM U1028, University Lyon 1, Lyon, France.
authors: Yannick
authors: Y
authors: Tholance
authors: 3 Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland.|4 BioRaN Team, Lyon Neuroscience Research Center, CNRS, UMR 5292, INSERM U1028, University Lyon 1, Lyon, France.
authors: Gleicy K
authors: GK
authors: Barcelos
authors: 4 BioRaN Team, Lyon Neuroscience Research Center, CNRS, UMR 5292, INSERM U1028, University Lyon 1, Lyon, France.|5 Laboratory of Neurobiology, Neurochemistry Unit, Department of Biochemistry and Molecular Biology, Hospices Civils de Lyon, Lyon, France.
authors: Armand
authors: A
authors: Perret-Liaudet
authors: 6 Neuro-Intensive Care Unit, Neurological Hospital, Hospices Civils de Lyon, Lyon, France.
authors: Edris
authors: E
authors: Omar
authors: 6 Neuro-Intensive Care Unit, Neurological Hospital, Hospices Civils de Lyon, Lyon, France.
authors: Romain
authors: R
authors: Carrillon
authors: 6 Neuro-Intensive Care Unit, Neurological Hospital, Hospices Civils de Lyon, Lyon, France.
authors: Sébastien
authors: S
authors: Grousson
authors: 2 TIGER Team, Lyon Neuroscience Research Center, CNRS, UMR 5292, INSERM U1028, University Lyon 1, Lyon, France.
authors: Thomas
authors: T
authors: Lieutaud
authors: 6 Neuro-Intensive Care Unit, Neurological Hospital, Hospices Civils de Lyon, Lyon, France.
authors: Frédéric
authors: F
authors: Dailler
authors: 2 TIGER Team, Lyon Neuroscience Research Center, CNRS, UMR 5292, INSERM U1028, University Lyon 1, Lyon, France.|7 AniRA-NeuroChem Technological Platform, Lyon Neuroscience Research Center, CNRS, UMR 5292, INSERM U1028, University Lyon 1, Lyon, France.
authors: Stéphane
authors: S
authors: Marinesco
mesh_terms: D000465:Algorithms; D002533:Cerebral Angiography / Q000379:methods; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D018810:Magnetic Resonance Angiography / Q000379:methods; D017551:Microdialysis; D064926:Neurophysiological Monitoring / Q000379:methods*; D010100:Oxygen / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism
chemical_list: D010100:Oxygen
keywords: Cerebral infarction; cerebral microdialysis; delayed cerebral ischemia; probe placement; subarachnoid haemorrhage