Sander D, Klingelhöfer J
Department of Neurology, Technical University of Munich, Germany.
Neurol Res. 1992 Sep;14(4):352-4. doi: 10.1080/01616412.1992.11740083.
A 40-year old patient with spontaneous subarachnoid haemorrhage and vasospasm in whom an acute rebleeding occurred during transcranial Doppler ultrasonography monitoring is reported. The Doppler recordings of the middle cerebral artery displayed an extreme modification in their configuration in the form of an orthograde systolic flow component with zero diastolic flow or an oscillating flow immediately after occurrence of rebleeding. Reoccurrence of a diastolic flow component in still markedly raised cerebrovascular resistance index could be demonstrated a short time later. Rebleeding in subarachnoid haemorrhage with preexisting vasospasm leads to a severe temporary disturbance of cerebral perfusion. The vasospasm is likely to lead to a delayed normalization of perfusion and thus to prolonged ischaemia.
本文报道了一名40岁自发性蛛网膜下腔出血并伴有血管痉挛的患者，其在经颅多普勒超声监测期间发生了急性再出血。大脑中动脉的多普勒记录显示，再出血发生后，其形态发生了极端改变，表现为正向收缩期血流成分而舒张期血流为零，或出现振荡血流。短时间后可证明，在脑血管阻力指数仍明显升高的情况下，舒张期血流成分再次出现。已有血管痉挛的蛛网膜下腔出血再出血会导致严重的暂时性脑灌注障碍。血管痉挛可能导致灌注延迟恢复正常，从而导致长时间缺血。
