ARTERIAL SPASM DYNAMICS IN PATIENTS WITH ANEURISM SUBARACHNOID HEMORRHAGES
Keywords:
aneurism subarachnoid hemorrhages, cerebral angiosmasmAbstract
Introduction: Cerebral angiosmasm is the main factor for poor prognosis while aneurism intracranial hemorrhages. Objective: to define the cerebral angiospasm dynamics and optimal term of surgical treatment in patients with aneurism intracranial hemorrhages. Materials and methods of research: 76 patients with subarachnoid aneurism hemorrhages, complicated by cerebral angiospasm development are included in the research. To define transcranial Doppler sonography indices causation from the day of hemorrhage methods of correlation and regress analysis were used. Results of research: Renewed regression demonstrates the growth of central tendency for systolic speed of blood stream up to the 10th day of clinical course with its further fall off. Dependence of diastolic blood velocity and average blood flow rate in the medial cerebral artery on the day was described by linear splineregression with two junctions, i. e. the 9th and the 10th day. From the disease onset till the 9th day diastolic blood flow speed and average blood flow rate were stable; the jump of values was observed on the 10th day. Starting from the 10th day there was regress and decline of intracraneal pressure. Similar changes took place in the а. cerebri anterior, а. cerebri posterior and arteria carotis interna. In patients with angiospasm the 9–10th day after subarachnoid aneurism hemorrhage is the term when the highest blood linear velocity rate and peripheral impendence in intracranial vessels figures are observed. Conclusions: Optimal terms for intracranial operational invasion in patients with angiospasm is the 10th day after hemorrhage as the date of the angiospasm regression beginning.
References
Транскраниальная допплерография в нейрохирургии / Б. В. Гайдар, В. Б. Семенютин, В. Е. Парфенов, Д. В. Свистов // СПб. : Элби, 2008. – 281 с.
Мацуга О. М. Практична реалізація системи Drozd в системі медичного моніторингу / О. М. Мацуга // Актуальні проблеми автоматизації та інформаційних технологій : зб. наук. праць / наук. ред. О. П. Приставка. – Дніпропетровськ : Вид. ДДУ, 2005. – Т. 9. – С. 22–33.
Transcranial Doppler for predicting delayed cerebral ischemia after subarachnoid hemorrhage / E. Carrera, J. M. Schmidt, M. Oddo [et al.] // Neurosurgery. – 2009. – Vol. 65 (2). – Р. 316–323.
Kanamaru K. Risk factors for vasospasm-induced cerebral infarct when both clipping and coiling are equally available / K. Kanamaru, H. Suzuki, W. Taki // Acta Neurochir Suppl. – 2015. – Vol. 120. – Р. 291–295.
IHAST Investiators: Acute postoperative neurological deterioration associated with surgery for ruptured intracranial aneurysm: incidence, predictors, and outcomes / K. B. Mahaney, M. M. Todd, E. O. Bayman, J. C. Torner // J Neurosurg. – 2012. – Vol. 116. – Р. 1267–1278.
Transcranial Doppler ultrasonography for diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage: mean blood flow velocity ratio of the ipsilateral and contralateral middle cerebral arteries / R. Nakae, H. Yokota, D. Yoshida, A. Teramoto // Neurosurgery. – 2011. – Vol. 69 (4). – Р. 876–883.
Predictors of excellent functional outcome in aneurysmal subarachnoid hemorrhage / M. Pegoli, J. Mandrekar, A. A. Rabinstein, G. J. Lanzino // Neurosurg. – 2014. – Vol. 12. – Р. 1–5.
European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage / T. Steiner, S. Juvela, A. Unterberg, C. Jung // Cerebrovasc Dis. – 2013. – N 35 (2). – P. 93–112.
Effect of Human Albumin on TCD Vasospasm, DCI, and Cerebral Infarction in Subarachnoid Hemorrhage: The ALISAH Study / J. I. Suarez, R. H. Martin, E. Calvillo [et al.] // Acta Neurochir Suppl. – 2015. – Vol. 120. – Р. 287–290.
Wintermarka M. Vasospasm after Subarachnoid Hemorrhage: Utility of Perfusion CT and CT Angiography on Diagnosis and Management / M. Wintermarka, N. U. Koc, W. C. Smithc // AJNR. – 2006. – N 27. – Р. 26–34.