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Admission angiographic cerebral circulation time may predict subsequent angiographic vasospasm after aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  18162893     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Angiographic cerebral vasospasm occurs in approximately 70% of patients hospitalized after aneurysmal subarachnoid hemorrhage (SAH) and is associated with poor outcome. In this study, we examined whether or not cerebral circulation time (CCT) measured with digital subtraction angiography was associated with angiographic vasospasm. METHODS: Patients who underwent cerebral angiography within 24 hours of SAH were analyzed. Contrast dye transit time from the arterial to the venous phase was measured to obtain CCT (supraclinoid internal carotid artery to parietal cortical veins) and microvascular CCT (cortical middle cerebral artery to parietal cortical veins). Patients with ruptured anterior circulation aneurysms and vasospasm on follow-up angiography (Group A) were compared with patients with SAH without vasospasm (Group B) and with normal control subjects (Group C). RESULTS: There were 20 patients in Group A (mean age, 51 +/- 13 yr), 17 patients in Group B (56 +/- 12 yr), and 98 patients in Group C (52 +/- 12 yr). CCT in patients in Group A (7.7 +/- 1.9 s) was significantly longer than those in Groups B (6.6 +/- 1.2 s; P = 0.005) and C (5.9 +/- 1 s; P < 0.001). Microvascular CCT in patients in Group A (7.1 +/- 1.8 s) was significantly longer than those in Groups B (6.1 +/- 1.2 s; P = 0.003) and C (5.4 +/- 0.9 s; P < 0.001). CONCLUSION: Prolonged CCT, a measurement of increased small vessel resistance, can be identified within 24 hours after SAH and is associated with subsequent angiographic vasospasm. These results suggest that microcirculation changes may be involved in vasospasm.
Authors:
Joshua D Udoetuk; Michael F Stiefel; Robert W Hurst; John B Weigele; Peter D LeRoux
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Neurosurgery     Volume:  61     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-28     Completed Date:  2008-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1152-9; discussion 1159-61     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19107, USA. judoetuk@mail.med.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebral Angiography / methods*
Cerebrovascular Circulation / physiology*
Female
Humans
Intracranial Aneurysm / complications*
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Statistics, Nonparametric
Subarachnoid Hemorrhage / complications*
Time Factors
Tomography, X-Ray Computed
Vasospasm, Intracranial / diagnosis*,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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