Regional cerebral blood flow in the acute stage of experimentally induced subarachnoid hemorrhage

1983 ◽  
Vol 58 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Felix Umansky ◽  
Thalia Kaspi ◽  
Mordechai N. Shalit

✓ Subarachnoid hemorrhage (SAH) was induced in 13 adult mongrel cats by a slow injection of fresh autogenous blood into the cisterna magna. Serial determinations of regional cerebral blood flow (rCBF) in the cortex and deep-seated areas (internal capsule, thalamus, and caudate nucleus) were made during the following 2 hours, while intracranial pressure (ICP) was maintained at normal values. A decrease in rCBF was observed in all the areas examined. This reduction followed a characteristic triphasic pattern with an initial steep decline immediately after the SAH. The clinical implications of these findings are discussed.

1972 ◽  
Vol 37 (1) ◽  
pp. 36-44 ◽  
Author(s):  
M. Peter Heilbrun ◽  
Jes Olesen ◽  
Niels A. Lassen

✓ Regional cerebral blood flow (rCBF) studies using the intra-arterial 133xenon method were performed on 10 patients with subarachnoid hemorrhage. Both preoperative and postoperative studies showed evidence of decreased flow in the entire hemisphere studied, and, in addition, evidence of focal ischemia, focal hyperemia, focal vasoparalysis, and often global impairment of autoregulation. The degree of flow abnormalities correlated well with the clinical grading of the neurological deficit. It is suggested that analysis of the state of autoregulation might be useful in determining the time for surgical intervention and that rCBF studies are important in defining the effects of drugs used to counteract the ischemic effects of spasm.


2003 ◽  
Vol 98 (6) ◽  
pp. 1227-1234 ◽  
Author(s):  
Peter Vajkoczy ◽  
Peter Horn ◽  
Claudius Thome ◽  
Elke Munch ◽  
Peter Schmiedek

Object. The goal of this study was to evaluate regional cerebral blood flow (rCBF) monitoring, performed using thermal-diffusion (TD) flowmetry, as a novel means for the bedside diagnosis of symptomatic vasospasm. Methods. Fourteen patients with high-grade subarachnoid hemorrhage (SAH) who underwent early clip placement for anterior circulation aneurysms were prospectively entered into the study. Thermal-diffusion microprobes were implanted into the white matter of vascular territories that were deemed at risk for developing symptomatic vasospasm. Data on arterial blood pressure, intracranial pressure, cerebral perfusion pressure, rCBF measurement obtained using a TD probe (TD-rCBF), cerebrovascular resistance (CVR), and blood flow velocities were collected at the patient's bedside. The diagnosis of symptomatic vasospasm was based on the manifestation of a delayed ischemic neurological deficit and/or a reduced territorial level of CBF as assessed using stable Xe-enhanced computerized tomography (CT) scanning in combination with vasospasm demonstrated by angiography. Bedside monitoring of TD-rCBF and CVR allowed the detection of symptomatic vasospasm. In the 10 patients with vasospasm the TD-rCBF decreased from 21 ± 4 to 9 ± 1 ml/100 g/min (mean ± standard error of the mean), whereas in the four other patients the TD-rCBF value remained unchanged (mean TD-rCBF = 25 ± 4 compared with 21 ± 4 ml/100 g/min). A comparison of the results of TD-rCBF and Xe-enhanced CT studies, as well as the calculation of sensitivities, specificities, predictive values, and likelihood ratios, identified a TD-rCBF value of 15 ml/100 g/min as a reliable cutoff for the diagnosis of symptomatic vasospasm. In addition, TD flowmetry was characterized by a more favorable diagnostic reliability than transcranial Doppler ultrasonography. Conclusions. Thermal-diffusion flowmetry represents a promising method for the bedside monitoring of patients with SAH to detect symptomatic vasospasm. This is of major clinical interest for patients with high-grade SAH, who often cannot be assessed neurologically.


1972 ◽  
Vol 36 (4) ◽  
pp. 463-470 ◽  
Author(s):  
Samuel S. Kasoff ◽  
Lawrence H. Zingesser ◽  
Kenneth Shulman

✓ Regional cerebral blood flow (CBFr) and compartmental analysis in a series of children with closed head injuries have demonstrated abnormalities of both rate and distribution of blood flow. The most frequent derangement was a triphasic flow pattern overlying one or more regions of traumatized brain. The rate of flow in this third compartment is two to five times the rate of normal gray matter flow; while the relative weight of the compartment varies between 3.5% and 15%. The pathophysiology of this third, rapid compartment of flow is discussed, and the argument put forth that such flow does not represent hyperperfusion but rather an ischemia of the gray matter because such blood flow is not available to the tissue for nutrition. If this is so, it may well be a cause of permanent sequelae in the pediatric age group.


2008 ◽  
Vol 18 (4) ◽  
pp. 237-243 ◽  
Author(s):  
Stella Blasel ◽  
Elke Hattingen ◽  
Edgar Dettmann ◽  
Gerald Morawe ◽  
Friedhelm Zanella ◽  
...  

1985 ◽  
Vol 62 (4) ◽  
pp. 539-546 ◽  
Author(s):  
William J. Powers ◽  
Robert L. Grubb ◽  
Roy P. Baker ◽  
Mark A. Mintun ◽  
Marcus E. Raichle

✓ Regional cerebral blood flow (rCBF) and regional cerebral metabolic rate of oxygen (rCMRO2) were measured by positron emission tomography (PET) in four patients with subarachnoid hemorrhage and hemiparesis due to cerebral vasospasm. With resolution of the vasospasm, two patients recovered and two remained hemiparetic. Contralateral to the hemiparesis, rCBF was slightly higher in the two patients who eventually recovered (15.0 and 16.2 ml/100 gm/min) than in the two who remained hemiparetic (12.0 and 11.7 ml/100 gm/min). The rCMRO2 measurements showed similar differences, with values of 1.34 and 2.60 ml/100 gm/min in the patients who recovered, and 0.72 and 1.66 ml/100 gm/min in those who did not. These preliminary findings indicate that with PET studies it may be possible to prospectively differentiate patients with neurological deficits due to reversible ischemia from patients with irreversible infarction.


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