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Monitoring of Cerebral Hemodynamics and Oxygenation to Detect Delayed Ischemic Neurological Deficit After Aneurysmal Subarachnoid Hemorrhage

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Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 115))

Abstract

One of the major goals in the treatment of patients with aneurysmal subarachnoid hemorrhage (aSAH) is early detection and treatment of delayed ischemic neurologic deficits (DINDs) to prevent cerebral infarction and thus poor outcome or even death. The complex changes of cerebral metabolism, hemodynamics, and oxygenation after SAH are underestimated if they are considered exclusively based on angiographic cerebral vasospasm (CVS). The discrepancies on one hand may arise from the heterogeneous and complex pathophysiology of DINDs. On the other hand, the occurrence of DINDs may depend on the relationship between local cerebral oxygen delivery and demand, which can only be determined if cerebral blood flow (CBF) and the cerebral metabolic rate of oxygen (CMRO2) can be measured. We briefly review the most relevant methods for monitoring cerebral hemodynamics and oxygenation and discuss the limitations associated with early diagnosis of DINDs in patients with severe aSAH not amenable for clinical neurological examination.

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Conflicts of Interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Neurointensive Care Unit, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland

    Martin Seule, Carl Muroi, Christopher Sikorski & Emanuela Keller

Authors
  1. Martin Seule
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  2. Carl Muroi
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  3. Christopher Sikorski
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  4. Emanuela Keller
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Corresponding author

Correspondence to Emanuela Keller .

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Editors and Affiliations

  1. , Department of Neurosurgery, University of Cincinnati, Stetson, Suite 2200 260, Cincinnati, 45267-0515, Ohio, USA

    Mario Zuccarello

  2. College of Medicine, Department of Neurology, University of Cincinnati, Albert Sabin Way 231MSB room 1, Cincinnati, 46267-0536, Ohio, USA

    Joseph F. Clark

  3. College of Medicine, Dept. of Neurology and Neurosurgery, University of Cincinnati, Albert Sabin Way 231ML0517, Cincinnati, 45267-0517, Ohio, USA

    Gail Pyne-Geithman

  4. College of Medicine, Dept. of Neurosurgery, University of Cincinnati, Stetson St. Suite 260ML0515, Cincinnati, 45219, Ohio, USA

    Norberto Andaluz

  5. College of Medicine, Dept. of Neurosurgery, University of Cincinnati, Stetson, Suite 2200 260, Cincinnati, 45219, Ohio, USA

    Jed A. Hartings

  6. , Dept. of Emergency Medicine, University of Cincinnati, Albert Sabin Way 231ML0769, Cincinnati, 45267-0769, Ohio, USA

    Opeolu M. Adeoye

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Seule, M., Muroi, C., Sikorski, C., Keller, E. (2013). Monitoring of Cerebral Hemodynamics and Oxygenation to Detect Delayed Ischemic Neurological Deficit After Aneurysmal Subarachnoid Hemorrhage. In: Zuccarello, M., Clark, J., Pyne-Geithman, G., Andaluz, N., Hartings, J., Adeoye, O. (eds) Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 115. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1192-5_13

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  • DOI: https://doi.org/10.1007/978-3-7091-1192-5_13

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  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1191-8

  • Online ISBN: 978-3-7091-1192-5

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