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Sequential changes of cerebral blood flow after aneurysmal subarachnoid haemorrhage

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Summary

A total of 226 measurements of cerebral blood flow (CBF) were performed in 96 postoperative patients with aneurysmal subarachnoid haemorrhage (SAH). The global CBF was significantly reduced in the first week after SAH, and the extent of the CBF reduction was less in the patients with good outcome than in those with fair/ poor outcome. The good outcome patients showed a progressive increase in CBF in the following 3 weeks. Although the CBF decreased further in the second week in some of those patients, it turned to a steady increase thereafter. On the other hand, in the fair/poor outcome patients CBF remained far below the normal control value for at least 3 months after SAH. When looking into the effect of age on CBF in the patients with good outcome, those in their thirties and forties had a significantly reduced CBF during the first 2 weeks, whereas in those in their fifties and sixties a significant reduction persisted for 3 months to 1 year after SAH. Management of the older patients needs special attention even if they are apparently in good clinical condition, since the CBF threshold to ischaemia is diminished.

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References

  1. Bergvall U, Steiner L, Forster DMC (1973) Early pattern of cerebral circulatory disturbances following subarachnoid haemorrhage. Neuroradiology 5: 24–32

    Google Scholar 

  2. Dernbach PD, Little JR, Jones SC, Ebrahim ZY (1988) Altered cerebral autoregulation and CO2 reactivity after aneurysmal subarachnoid haemorrhage. Neurosurgery 22: 822–826

    Google Scholar 

  3. Gelmers HJ, Beks JWF, Journée HL (1979) Regional cerebral blood flow in patients with subarachnoid haemorrhage. Acta Neurochir (Wien) 47: 245–251

    Google Scholar 

  4. Géraud G, Tremoulet M, Guell A, Bes A (1984) The prognostic value of noninvasive CBF measurement in subarachnoid haemorrhage. Stroke 15: 301–305

    Google Scholar 

  5. Grubb RL Jr, Raichle ME, Eichling JO, Gado MH (1977) Effects of subarachnoid haemorrhage on cerebral blood volume, blood flow, and oxygen utilization in humans. J Neurosurg 46: 446–453

    Google Scholar 

  6. Heilbrun MP, Olesen J. Lassen NA (1972) Regional cerebral blood flow studies in subarachnoid haemorrhage. J Neurosurg 37: 36–44

    Google Scholar 

  7. Hunt WE, Hess RM (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 14–20

    Google Scholar 

  8. Ishii R (1979) Regional cerebral blood flow in patients with ruptured intracranial aneurysms. J Neurosurg 50: 587–594

    Google Scholar 

  9. James IM (1968) Changes in cerebral blood flow and in systemic arterial pressure following spontaneous subarachnoid haemorrhage. Clin Sci 35: 11–22

    Google Scholar 

  10. Kawase T, Mizukami M, Tazawa T, Araki G (1981) Critical flow levels in cerebral ischaemia. II. Vasospasm following subarachnoid haemorrhage. No To Shinkei 33: 61–69(Jpn)

    Google Scholar 

  11. Knuckey NW, Fox RA, Surveyor I, Stokes BAR (1985) Early cerebral blood flow and computerized tomography in predicting ischaemia after cerebral aneurysm rupture. J Neurosurg 62: 850–855

    Google Scholar 

  12. Maroon JC, Nelson PB (1979) Hypovolemia in patients with subarachnoid haemorrhage: Therapeutic implications. Neurosurgery 4: 223–226

    Google Scholar 

  13. Matsuzaki T, Mizukami M. Kawase T, Tazawa T (1981) Angiographic vasospasm and regional cerebral blood flow in the cases of ruptured aneurysm. Correlation between vasospasm in the middle cerebral artery and delayed ischaemic hemiparesis. No Shinkei Geka 9: 1511–1516 (Jpn)

    Google Scholar 

  14. Meinig G, Ulrich P, Pesch R, Schürmann K (1985) nrCBF for the assessment of cerebrovascular spasm and the timing of angiography and operation in subarachnoid haemorrhage. In: Hartmann A, Hoyer S (eds) Cerebral blood flow and metabolism measurement. Springer, Berlin Heidelberg New York Tokyo, pp 172–179

    Google Scholar 

  15. Messeter K, Brandt L, Ljunggren B, Svendgaard NA, Algotsson L, Romner B, Ryding E (1987) Prediction and prevention of delayed ischaemic dysfunction after aneurysmal subarachnoid haemorrhage and early operation. Neurosurgery 20: 548–553

    Google Scholar 

  16. Meyer CHA, Lowe D, Meyer M, Richardson PL, Neil-Dwyer G (1983) Progressive change in cerebral blood flow during the first three weeks after subarachnoid haemorrhage. Neurosurgery 12: 58–76

    Google Scholar 

  17. Meyer JS, Ishihara N, Deshmukh VD, Naritomi H, Sakai F, Hsu MC, Pollack P (1978) Improved method for non-invasive measurement of regional cerebral blood flow by133Xenon inhalation. Part I. Description of the method and normal values obtained in healthy volunteers. Stroke 9: 195–205

    Google Scholar 

  18. Mickey B, Vorstrup S, Voldby B, Lindewald H, Harmsen A, Lassen NA (1984) Serial measurement of regional cerebral bloodflow in patients with SAH using133Xenon inhalation and emission computerized tomography. J Neurosurg 60: 916–922

    Google Scholar 

  19. Naritomi H, Meyer JS, Sakai F, Yamaguchi F, Shaw T (1979) Effects of advancing age on regional cerebral blood flow. Studies in normal subjects and subjects with risk factors for atherothrombotic stroke. Arch Neurol 36: 410–416

    Google Scholar 

  20. Pitts LH, MacPherson P, Wyper DJ, Jennett B, Blair I, Cooke MBD (1980) Effects of vasospasm on cerebral blood flow after subarachnoid haemorrhage. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 333–337

    Google Scholar 

  21. Powers WJ, Grubb RL Jr., Baker RP, Mintun MA, Raichle ME (1985) Regional cerebral blood flow and metabolism in reversible ischaemia due to vasospasm. Determination by positron emission tomography. J Neurosurg 62: 539–546

    Google Scholar 

  22. Risberg J, Ali Z, Wilson EM, Wills EL, Halsey JH Jr (1975) Regional cerebral blood flow by133Xenon inhalation. Preliminary evaluation of an initial slope index in patients with unstable flow compartment. Stroke 6: 142–148

    Google Scholar 

  23. Ropper AH, Zervas NT (1984) Outcome 1 year after SAH from cerebral aneurysm. Management morbidity, mortality, and functional status in 112 consecutive good-risk patients. J Neurosurg 60: 909–915

    Google Scholar 

  24. Rosenstein J, Wang AD, Symon L, Suzuki M (1985) Relationship between hemispheric cerebral blood flow, central conduction time, and clinical grade in aneurysmal subarachnoid haemorrhage. J Neurosurg 62: 25–30

    Google Scholar 

  25. Sakaki S, Yano M, Kohno K, Kuwabara H, Matsuoka K (1983) Regional cerebral blood flow studies in patients with ruptured intracranial aneurysms. No Sotchu 5: 38–45 (Jpn)

    Google Scholar 

  26. Säveland H, Sonesson B, Ljunggren B, Brandt L, Uski T, Zygmunt S, Hindfelt B (1986) Outcome evaluation following subarachnoid haemorrhage. J Neurosurg 64: 191–196

    Google Scholar 

  27. Solomon RA, Post KD, McMurtry JG III (1984) Depression of circulating blood volume in patients after subarachnoid haemorrhage: Implications for the management of symptomatic vasospasm. Neurosurgery 15: 354–361

    Google Scholar 

  28. Voldby B, Enevoldsen EM, Jensen FT (1985) Regional CBF, intraventricular pressure, and cerebral metabolism in patients with ruptured intracranial aneurysms. J Neurosurg 62: 48–58

    Google Scholar 

  29. Yamagata S, Kikuchi H, Ihara I, Nagata I, Morooka Y, Naruo Y, Koizumi T, Hashimoto K, Minamikawa J, Miyamoto S, Mitsuno K, Matsumoto M, Yamazoe N, Akiyama Y (1988) Cerebral blood flow as a prognostic indication in subarachnoid hemorrhage. Neurol Med Chir (Tokyo) 28: 333–339 (Jpn)

    Google Scholar 

  30. Yamakami I, Isobe K, Yamaura A, Nakamura T, Makino H (1983) Vasospasm and regional cerebral blood flow (rCBF) in patients with ruptured intracranial aneurysm: Serial rCBF studies with the xenon-133 inhalation method. Neurosurgery 13: 394–401

    Google Scholar 

  31. Yamamoto M, Meyer JS, Naritomi H, Sakai F, Yamaguchi F, Shaw T (1979) Noninvasive measurement of cerebral vasospasm in patients with subarachnoid haemorrhage. J Neurol Sci 43: 301–311

    Google Scholar 

  32. Yonas H, Sekhar L, Johnson DW, Gur D (1989) Determination of irreversible ischaemia by xenon-enhanced computed tomographic monitoring of cerebral blood flow in patients with symptomatic vasospasm. Neurosurgery 24: 368–372

    Google Scholar 

  33. Zingesser LH, Schechter MM, Dexter J, Katzman R, Scheinberg LC (1968) On the significance of spasm associated with rupture of a cerebral aneurysm. The relationship between spasm as noted angiographically and regional blood flow determinations. Arch Neurol 18: 520–528

    Google Scholar 

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  1. Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Japan

    M. Matsuda, A. Shiino & J. Handa

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  1. M. Matsuda
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  2. A. Shiino
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  3. J. Handa
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Matsuda, M., Shiino, A. & Handa, J. Sequential changes of cerebral blood flow after aneurysmal subarachnoid haemorrhage. Acta neurochir 105, 98–106 (1990). https://doi.org/10.1007/BF01669990

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