Neuroradiology

, Volume 41, Issue 6, pp 453–462

Endovascular treatment of cerebral vasospasm: assessment of treatment effect by cerebral angiography and transcranial colour Doppler sonography

  • B. Schuknecht
  • J. Fandino
  • C. Yüksel
  • Y. Yonekawa
  • A. Valavanis
INTERVENTIONAL NEURORADIOLOGY

DOI: 10.1007/s002340050784

Cite this article as:
Schuknecht, B., Fandino, J., Yüksel, C. et al. Neuroradiology (1999) 41: 453. doi:10.1007/s002340050784

Abstract

In a retrospective study of 30 consecutive patients with symptomatic vasospasm the mean degree of narrowing as compared to the initial angiogram was 35 % (± 24 %) in 12 intradural internal carotid arteries (ICA), 42 % (± 17 %) in 42 proximal middle cerebral (MCA) and 38 % (± 19 %) in 27 anterior cerebral arteries (ACA). The corresponding increase in mean flow velocities from baseline values obtained by transcranial colour Doppler sonography (TCD) within 12 h of the first angiogram to the time of clinical vasospasm was considerably higher, with 49 % (± 34 %) in the ICA, 119 % (± 92 %) in the MCA and 147 % (± 170 %) in the ACA. Following superselective intra-arterial papaverine application in 66 arteries and balloon angioplasty of 15 arteries, 78 (96.3 %) of 81 dilated. Sustained clinical improvement was achieved in 22 patients (73.3 %). The mean reversal of angiographic vasospasm was 71 % for the ICA (range 10–100 %), 81 % for the MCA (range 9–100 %) and 82 % (range 0–100 %) for the A1 segment. The mean reduction of flow velocities after treatment was much less with 23 % (± 21 %) in the ICA, 32 % (± 24 %) in the MCA and 25 % (± 22 %) in the A1 segment.

Key words Vasospasm cerebral Sonography transcranial colour Doppler Balloon angioplasty Papaverine 

Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • B. Schuknecht
    • 1
  • J. Fandino
    • 2
  • C. Yüksel
    • 1
  • Y. Yonekawa
    • 2
  • A. Valavanis
    • 1
  1. 1.Institute of Neuroradiology, University Hospital Zurich, CH-8091 Zurich, Switzerland Tel.: + 41-1-2 55 56 00 Fax: + 41-1-2 55 45 04CH
  2. 2.Department of Neurosurgery, University Hospital Zurich, SwitzerlandCH

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