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Critical increase of blood flow velocities after subarachnoid haemorrhage: vasospasm versus hyperaemia
J Meixensberger1, B Hamelbeck, J Dings
1Department for Neurosurgery, University of Würzburg.
Thirty cases of subarachnoid haemorrhage (SAH), who underwent early aneurysm clipping, were studied to clarify the significance of a critical increase of blood flow velocities in correlation to neurological disability and cerebral blood flow. Three different groups of patients could be distinguished: 57% (17) of the cases showed increased TCD-values at the affected side corresponding to secondary neurological deficits (Vasospasm-group). The CBF-results pointed out a side difference according to the flow acceleration. In 7 patients (23%) we detected a similar side difference in blood flow velocity, but no secondary deficit appeared. The corresponding CBF-measurements showed risen values with no side difference (Hyperaemia-group). The third group of patients (20% i.e.6 cases) developed neurological deficits and corresponding side difference in CBF-measurements, but the transcranial Doppler sonography could not detect a significant side difference and even showed normal values (Blind-TCD-group). Critical increased blood flow velocities after SAH without secondary neurological deficits does not indicate vasospasm but hyperaemia.
Thirty cases of subarachnoid haemorrhage (SAH), who underwent early aneurysm clipping, were studied to clarify the significance of a critical increase of blood flow velocities in correlation to neurological disability and cerebral blood flow. Three different groups of patients could be distinguished: 57% (17) of the cases showed increased TCD-values at the affected side corresponding to secondary neurological deficits (Vasospasm-group). The CBF-results pointed out a side difference according to the flow acceleration. In 7 patients (23%) we detected a similar side difference in blood flow velocity, but no secondary deficit appeared. The corresponding CBF-measurements showed risen values with no side difference (Hyperaemia-group). The third group of patients (20% i.e.6 cases) developed neurological deficits and corresponding side difference in CBF-measurements, but the transcranial Doppler sonography could not detect a significant side difference and even showed normal values (Blind-TCD-group). Critical increased blood flow velocities after SAH without secondary neurological deficits does not indicate vasospasm but hyperaemia.