Summary
In order to explore the applicability of daily cerebral autoregulation monitoring through routine utilization of the transient hyperaemic response (THR) test in patients after aneurysmal subarachnoid haemorrhage (SAH), we performed THR tests daily in 50 consecutive patients with verified SAH.
Out of 1167 studies, the test results were acceptable during 954 procedures (81.5%). 310 negative (32.5%; range 0.75–1.099; mean 1.03) and 644 positive (67.5%; range 1.10–1.77; mean 1.19) test results were obtained. Multiple logistic regression analysis revealed that the registration of negative THR in a middle cerebral artery (MCA) during the period of critical care was related to the patients’ poor clinical grade (p-0.02) and Fisher CT-grade (p-0.04) on admission, to the development of vasospasm (p-0.003) and to the detection of ipsilateral intracerebral haemorrhage and/or cerebral infarction (p-0.01). The frequent registration of negative THR tests (negative results in >30% of all the tests in an MCA) was independently related to the detection of ipsilateral intracerebral haemorrhage and/or cerebral infarction (p-0.0001).
THR tests provide information about intracranial alterations and can be safely performed as a routine monitoring tool after SAH.
This stydy was supported by grant No. 4333 from the Estonian Science Foundation
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Anonymous (1988) Report of World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg 68: 985–986
Czosnyka M, Pickard J, Whitehouse H, Piechnik S (1992) The hyperaemic response to a transient reduction in cerebral perfusion pressure. A modelling study. Acta Neurochir (Wien) 115: 90–97
Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6: 1–9
Giller CA (1991) A bedside test for cerebral autoregulation using transcranial Doppler ultrasound. Acta Neurochir (Wien) 108: 7–14
Lindegaard KF, Nornes H, Bakke SJ, Sorteberg W, Nakstad P (1988) Cerebral vasospasm aftersubarachnoid haemorrhage investigated by means of transcranial Doppler ultrasound. Acta Neurochir (Wien) [Suppl] 42: 81–84
Smielewski P, Czosnyka M, Iyer V, Piechnik S, Whitehouse H, Pickard J (1995) Computerised transient hyperaemic response test — a method for the assessment of cerebral autoregulation. Ultrasound Med Biol 21: 599–611
Smielewski P, Czosnyka M, Kirkpatrick P, McEroy H, Rutkowska H, Pickard JD (1996) Assessment of cerebral autoregulation using carotid artery compression. Stroke 27: 2197–2203
Smielewski P, Czosnyka M, Kirkpatrick P, Pickard JD (1997) Evaluation of the transient hyperemic response test in headinjured patients. J Neurosurg 86: 773–778
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2: 81–84
van Gijn J, Hijdra A, Wijdicks EF, Vermeulen M, van Crevel H (1985) Acute hydrocephalus after aneurysmal subarachnoid hemorrhage. J Neurosurg 63: 355–362
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer-Verlag
About this paper
Cite this paper
Rätsep, T., Eelmäe, J., Asser, T. (2002). Routine Utilization of the Transient Hyperaemic Response Test after Aneurysmal Subarachnoid Haemorrhage. In: Czosnyka, M., Pickard, J.D., Kirkpatrick, P.J., Smielewski, P., Hutchinson, P. (eds) Intracranial Pressure and Brain Biochemical Monitoring. Acta Neurochirurgica Supplements, vol 81. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6738-0_31
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6738-0_31
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7397-8
Online ISBN: 978-3-7091-6738-0
eBook Packages: Springer Book Archive