Year: 1989
Type: article
Study design: Observational Study
Abstract: Noninvasive diagnostic methods of transcranial Doppler (TCD) sonography and single photon ECT (SPECT) were used for predicting vasospasm in 41 cases with ruptured cerebral aneurysm in the acute stage. The degree of vasospasm in the M1 segment of the affected middle cerebral artery (MCA) was evaluated according to Fisher's classification on angiograms conducted between seven and 11 days after the last attack. Mean flow velocity in the affected M1 segment was serially measured by TCD during the 14 days after the last attack in 24 cases. CBF was measured by SPECT with Xe-133 inhalation between seven and 13 days after the last attack in 26 cases. Mean CBF was calculated in the affected MCA region.Four cases with no vasospasm in the M1 segment on the angiogram showed no alteration in mean flow velocity for the same segment. Nine cases with slight to moderate vasospasm on the angiogram included six cases which revealed a mild increase in mean velocity, and three cases which showed no change. Of 11 cases with severe vasospasm demonstrated angiographically, three cases showed a marked increase in mean velocity; a mild increase was recognized in seven cases; and one case showed no change. On the contrary, there was no apparent difference in the change of mean flow velocity between cases with or without neurological deterioration due to vasospasm. Mean CBF value for the affected MCA region in the cases with severe vasospasm on the angiogram was slightly lower than the value for those who were not affected severely. However, mean CBF value in the cases with neurological deterioration due to vasospasm was markedly lower than that without the deterioration.The above results suggest that the changes in flow velocity in the M1 segment measured by TCD show the severity of vasospasm on the angiogram. On the other hand, mean CBF value measured by SPECT would be a useful indicator of subsequent neurological deterioration following the vasospasm rather than of the evaluation of vasospasm demonstrated on the angiogram. Therefore, noninvasive prediction of vasospasm and subsequent neurological deterioration using TCD and SPECT would be useful in elucidating the pathophysiology and the course of treatment of vasospasm.
Source: Surgery for Cerebral Stroke
Institution: Chugoku Rosai Hospital
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W375479659