| A diagnostic flowchart, including TCD, Xe-CT and angiography, to improve the diagnosis of vasospasm critically affecting cerebral blood flow in patients with subarachnoid haemorrhage, sedated and ventilated. | |
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MedLine Citation:
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PMID: 19382372 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to prospectively evaluate a clinical protocol including transcranial doppler (TCD), Xenon-CT (Xe-CT) and angiography, for the detection of vasospasm leading to critical reductions of regional cerebral blood flow (rCBF) in both ventilated and sedated SAH patients, i.e. patients in whom clinical evaluation was not possible. Seventy-six patients were prospectively included in a surveillance protocol for daily TCD vasospasm monitoring. When TCD showed a V(mean) above 120 cm/sec in the middle cerebral artery (MCA), patients underwent Xe-CT study. If rCBF in the MCA was reduced to below 20 ml/100 g/min or if there was a reduction in the rCBF with significant asymmetry between the two MCAs, angiography was performed. Conversely, further Xe-CT and angiography were not obtained unless the TCD V(mean) values reached values above 160 cm/sec. In 35 patients, V(mean) attained values above 120 cm/sec, but only in five of them, rCBF was suggestive of vasospasm, and angiography confirmed the diagnosis in four. The protocol suggests that in sedated and ventilated patients, detection of a critical rCBF reduction due to vasospasm is possible to allow for more specific treatment and to reduce undue medical complications. |
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Authors:
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A Chieregato; R Battaglia; G Sabia; C Compagnone; F Cocciolo; F Tagliaferri; R Pascarella; U Pasquini; M Frattarelli; L Targa |
Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Acta neurochirurgica. Supplement Volume: 104 ISSN: 0065-1419 ISO Abbreviation: Acta Neurochir. Suppl. Publication Date: 2008 |
Date Detail:
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Created Date: 2009-04-21 Completed Date: 2009-06-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100962752 Medline TA: Acta Neurochir Suppl Country: Austria |
Other Details:
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Languages: eng Pagination: 251-3 Citation Subset: IM |
Affiliation:
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Unitá Operativa Anestesia e Rianimazione, Ospedale M. Bufalini, Viale Ghirotti 286, 47023 Cesena, Italy. achiere@ausl-cesena.emr.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiography Brain / blood supply Deep Sedation Humans Middle Cerebral Artery / radiography, ultrasonography Prospective Studies Regional Blood Flow Respiration, Artificial Subarachnoid Hemorrhage / complications* Tomography, X-Ray Computed Ultrasonography, Doppler, Transcranial Vasospasm, Intracranial / etiology, radiography*, ultrasonography* Xenon |
| Chemical | |
Reg. No./Substance:
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7440-63-3/Xenon |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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