Journal ArticleDOI
Cerebral vasospasm evaluated by transcranial ultrasound correlated with clinical grade and CT-visualized subarachnoid hemorrhage
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TLDR
Maximum FV's over 200 cm/sec were associated with a tendency for ischemia, but the patients may remain clinically asymptomatic, whereas, with thick clots of subarachnoid blood, there was a steeper and higher increase of mean FV't.Abstract:
In 39 patients with a proven subarachnoid hemorrhage (SAH), the clinical status, the amount of subarachnoid blood on a computerized tomography scan obtained within 5 days after SAH, and the flow velocities (FV's) in both middle cerebral arteries (MCA's) measured by transcranial Doppler sonography were recorded daily and correlated. All patients had pathological FV's over 80 cm/sec between Day 4 and Day 10 after SAH. The side of the ruptured aneurysm showed higher FV's than did the unaffected side in cases of laterally localized aneurysms. Increase in FV preceded clinical manifestation of ischemia. A step early increase of FV's portended severe ischemia and impending infarction. Maximum FV's in the range of 120 to 140 cm/sec were not critical and in no case led to brain infarction. Maximum FV's over 200 cm/sec were associated with a tendency for ischemia, but the patients may remain clinically asymptomatic. In cases of no or only a little blood in the basal cisterns, mean FV's in both MCA's increased only moderately whereas, with thick clots of subarachnoid blood, there was a steeper and higher increase of mean FV's.read more
Citations
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Cerebral vasospasm diagnosis by means of angiography and blood velocity measurements.
TL;DR: Investigation of patients with known subarachnoid haemorrhage and non-invasive Doppler recordings of cerebral artery blood velocity indicates that with regard to diagnosing cerebral vasospasm, the reliability of blood velocity measurements match the reliable of judging angiograms visually.
Journal ArticleDOI
Delayed cerebral vasospasm and nitric oxide: review, new hypothesis, and proposed treatment.
TL;DR: A two-stage hypothesis of pathogenesis of delayed cerebral vasospasm is presented developed in the Vascular Laboratory of Surgical Neurology Branch of the National Institute of Neurological Disorders and Stroke using a primate model of SAH and suggests that the key treatment should be focused on preventing oxyHb neurotoxicity, inhibiting BOX production, and exogenous NO delivery.
Journal ArticleDOI
Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage
M. A. Sloan,E. C. Haley,Neal F. Kassell,M. L. Henry,S. R. Stewart,R. R. Beskin,E. A. Sevilla,J. C. Tomer +7 more
TL;DR: Data suggest that TCD is a highly specific, but less sensitive test for the detection of angiographic vasospasm following SAH, and confirmatory angiography may be avoided if the TCD study is positive, but additional studies may be necessary if the clinical picture is suspicious and the T CD study is negative.
Journal ArticleDOI
Role of transcranial Doppler monitoring in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage
TL;DR: For individual patients, only low or very high middle cerebral artery flow velocities reliably predicted the absence or presence of clinically significant angiographic vasospasm after aneurysmal subarachnoid hemorrhage.
Journal ArticleDOI
Wartime traumatic cerebral vasospasm: recent review of combat casualties.
Rocco A. Armonda,Randy S. Bell,Alexander H. Vo,Geoffrey S.F. Ling,Thomas J. DeGraba,Benjamin Crandall,James Ecklund,William W. Campbell +7 more
TL;DR: Traumatic vasospasm occurred in a substantial number of patients with severe neurotrauma, and clinical outcomes were worse for those with this condition, however, aggressive open surgical and endovascular treatment strategies may have improved outcome.
References
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Journal ArticleDOI
Surgical Risk as Related to Time of Intervention in the Repair of Intracranial Aneurysms
William E. Hunt,Robert M. Hess +1 more
TL;DR: The modification of Botterell's classification 3 has been applied to 275 consecutive cases of intracranial aneurysm treated by the faculty and resident staff of the Ohio State University and affiliated hospitals over a 12year period and is of the opinion that a fairly sharp differentiation is possible among patients who have few or no meningeal signs, patients who has welldefined meningealing signs but no neurological deficit, and patients who show neurological malfunction.
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Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries
TL;DR: This transcranial Doppler method is of particular value for the detection of vasospasm following subarachnoid hemorrhage and for evaluating the cerebral circulation in occlusive disease of the carotid and vertebral arteries.
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Relation of Cerebral Vasospasm to Subarachnoid Hemorrhage Visualized by Computerized Tomographic Scanning
TL;DR: The results indicate that blood localized in the subarachnoid space in sufficient amount at specific sites is the only important etiological factor in vasospasm and it should be possible to identify patients in jeopardy from vasospasms and institute early preventive measures.
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Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound
TL;DR: The authors conclude, however, that the new method of measuring vasospasm will also detect spasm in the ACA if it has a hemodynamically significant effect upon flow resistance.
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Time course of vasospasm in man
TL;DR: Vasospasm has its onset in man about Day 3 after subarachnoid hemorrhage, is maximal at Days 6 to 8, and is gone by Day 12, and there is a tendency for patients in poor clinical grades to have more vasospasm.