Gupta Charitesh, Husain Mazhar, Kumar Manoj, Kohli Neera, Tiwari Vinod, Vatsal D K, Nirala A P
Department of Neurosurgery, King George's Medical College, Lucknow.
J Indian Med Assoc. 2004 Apr;102(4):191-2, 194, 196.
Transcranial Doppler (TCD) sonography is emerging as a new ultrasonography technology to look at the interaction between the brain parenchyma and perfusion during cerebrovascular accident. Before TCD sonography the vasospasm following subarachnoid haemorrhage could only be diagnosed either clinically or by invasive method ie, angiography. TCD has been proved as a wonderful non-invasive, repeatable, beat-by-beat, non-expensive technique for detection and follow-up of vasospasm after subarachnoid haemorrhage. In the present series 12 patients suspected to have vasospasm after subarachnoid haemorrhage were confirmed and monitored with the help of TCD. Most of the patients were clinically presented with increasing headache and altered sensorium. It is noticed that vasospasm following subarachnoid haemorrhage has a typical course, which has increasing trend after 4th day of subarachnoid haemorrhage and declining trend after 14th day onwards. Six out of 12 patients were in moderate grade of vasospasm, 2 out of 12 were in severe grade and 4 out of 12 were mild grade of severity.
经颅多普勒(TCD)超声检查正成为一种新的超声检查技术,用于观察脑血管意外期间脑实质与灌注之间的相互作用。在TCD超声检查出现之前,蛛网膜下腔出血后的血管痉挛只能通过临床诊断或侵入性方法(即血管造影)来诊断。TCD已被证明是一种出色的非侵入性、可重复、逐搏、低成本的技术,用于检测和随访蛛网膜下腔出血后的血管痉挛。在本系列研究中,12例疑似蛛网膜下腔出血后血管痉挛的患者通过TCD得到确诊并进行监测。大多数患者临床上表现为头痛加剧和意识改变。值得注意的是,蛛网膜下腔出血后的血管痉挛有一个典型的病程,在蛛网膜下腔出血第4天后呈上升趋势,从第14天起呈下降趋势。12例患者中有6例为中度血管痉挛,12例中有2例为重度,12例中有4例为轻度。