Incidence of Clinically Significant Cerebral Vasospasm in SAH Estimated by Local Cerebral Vasodilatory Capacity Using Acetazolamide-activated 123I-IMP SPECT
Year: 1991
Type: article
Study design: Observational Study
Abstract: The present study attempts to assess the incidence of clinically significant cerebral vasospasm in subarachnoid hemorrhage (SAH), estimated through serial changes of local cerebral vasodilatory capacity (CVC) using single photon emission computed tomography (SPECT) and Nisopropyl-I-123-p-iodoamphetamine (IMP) under acetazolamide (DIAMOX) -activated conditons. One-hundred fourteen patients who underwent early surgery for ruptured aneurysm in the carotid system were postoperatively examined weekly using DIAMOX-activated IMP SPECT.Estimating limitations in local CVC, serial changes of local CVC were “absent” in 16 patients (14%), “mild” in 52 (46%), and “moderate” in 46 (40%). The incidence of patients in the “moderate” group was significantly higher in preoperative Grades (Hunt & Kosnik) III and IV (53%-60%) than Grades I and II (23-30%)(p<0.001). The outcome of patients with limitation in local CVC was as follows: In the “mild” group, there was no morbidity and mortality due to vasospasm alone: Morbidity was mainly caused by initial brain damage. In the “moderate” group, morbidity was mainly caused by vasospasm and 4 patients (10%) died due to severe vasospasm. Therefore, moderate limitation in local CVC was clinically significant in predicting symptomatic vasospasm, because it was connected with transient or permanent neurological deteriorations.Assessment of CVC in patients with SAH might predict potential cerebral ischemia caused by the reduction of perfusion pressure due to cerebral vasospasm, and could be a useful tool for the current management of symptomatic vasospasm.
Source: Surgery for Cerebral Stroke
Institution: Nakamura Memorial Hospital
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2518666779