scholarly journals Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography

2011 ◽  
Vol 65 (4) ◽  
pp. 325
Author(s):  
Yong Hee Lee ◽  
Dae Seob Choi ◽  
Jae Wook Ryoo ◽  
Jin Jong You ◽  
Ho Cheol Choi ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Cerebral Vasospasm ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Digital Subtraction ◽  
Multidetector Row Ct ◽  
Multidetector Row

scholarly journals Delayed Cerebral Ischemia and Spreading Depolarization in Absence of Angiographic Vasospasm after Subarachnoid Hemorrhage

2011 ◽  
Vol 32 (2) ◽  
pp. 203-212 ◽  
Author(s):  
Johannes Woitzik ◽  
Jens P Dreier ◽  
Nils Hecht ◽  
Ingo Fiss ◽  
Nora Sandow ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Digital Subtraction Angiography ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Prolonged Release ◽  
Digital Subtraction ◽  
Angiographic Vasospasm ◽  
Electrode Strip ◽  
Subdural Electrode

It has been hypothesized that vasospasm is the prime mechanism of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). Recently, it was found that clusters of spreading depolarizations (SDs) are associated with DCI. Surgical placement of nicardipine prolonged-release implants (NPRIs) was shown to strongly attenuate vasospasm. In the present study, we tested whether SDs and DCI are abolished when vasospasm is reduced or abolished by NPRIs. After aneurysm clipping, 10 NPRIs were placed next to the proximal intracranial vessels. The SDs were recorded using a subdural electrode strip. Proximal vasospasm was assessed by digital subtraction angiography (DSA). 534 SDs were recorded in 10 of 13 patients (77%). Digital subtraction angiography revealed no vasospasm in 8 of 13 patients (62%) and only mild or moderate vasospasm in the remaining. Five patients developed DCI associated with clusters of SD despite the absence of angiographic vasospasm in three of those patients. The number of SDs correlated significantly with the development of DCI. This may explain why reduction of angiographic vasospasm alone has not been sufficient to improve outcome in some clinical studies.

Sign in / Sign up

Export Citation Format

Share Document