The Value of Hemodynamic Measurements in the Early Stage of Subarachnoid Hemorrhage
The rupture of a cerebral aneurysm is linked with a reversible derangement of cerebral hemodynamics that can lead to focal or global ischemia, more frequently around the end of the first week after hemorrhage, when the damage caused by the initial bleed has become stable or has already subsided . By an accepted definition, these subacute or delayed ischemic disturbances go under the term of cerebral vasospasm , because in this subacute period the cerebral vessels appear generally constricted at angiography . However, the lack of correlation between the extension and severity of angiographical vasospasm and the development of clinical symptoms suggests that vessel constriction is only a secondary or complicating factor, and that the primary cause of these disturbances is an impairment of cerebral perfusion, produced by the initial hemorrhage.
KeywordsDepression Ischemia Xenon Nial Nimodipine
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- 6.Grubb RL, Raichle ME, Eichling JO, Gado MH (1977) Effects of subarachnoid hemorrhage on cerebral blood flow, blood volume and oxygen utilization in humans. J Neurosurg 46: 453–466Google Scholar
- 21.Kontos HA (1989) Validity of cerebral arterial blood flow calculations from velocity measurements. Stroke 20:1–3Google Scholar
- 29.Lindegaard KF, Nornes H, Bakke SJ, Sorteberg W, Nakstad P (1989) Cerebral vasospasm: Diagnosis by means of angiography and blood velocity measurements. Acta Neurochir 100: 12–24Google Scholar
- 32.Seiler RW, Reulen HJ, Huber P, Grolimund P, Ebeling U, Steiger HJ (1988) Outcome of aneurysmal subarachnoid hemorrhage in a hospital population: A prospective study including early Operation, intravenous nimodipine, and transcranial Doppler ultrasound. Neurosurgery 23: 598–604PubMedCrossRefGoogle Scholar
- Newell DW, Frady MS, Eskridge JM, Winn HR (1990) Distribution of angiographic vasospasm after subarachnoid hemorrhage: Implications for diagnosis by transcranial Doppler ultrasonography. Neurosurgery 27: 574–577Google Scholar