Carter L P, Grahm T, Zabramski J M, Dickman C A, Lopez L J, Tallman D H, Spetzler R F
University of Arizona Medical Center, Tucson 85724.
Neurol Res. 1990 Dec;12(4):214-8. doi: 10.1080/01616412.1990.11739945.
Fifteen patients harbouring intracranial aneurysms were monitored postoperatively. A thermal diffusion flow probe was placed on the cortex, in an area of interest, and continuous recording of cerebral blood flow (CBF) was carried out for 1-4 days. Vasospasm can also be detected by clinical deterioration, increased velocity by transcranial Doppler, and by angiographical evidence of decrease in vessel calibre. A comparison was made between these methods of determining vasospasm and changes in CBF. Three patients had unruptured aneurysms and no evidence of vasospasm. These patients had a range of CBF from 44 to 100 cc 100 g-1 min-1 with a daily mean of 78 cc 100 g-1 min-1. One patient was operated on, in a delayed fashion, after a period of vasospasm on post-subarachnoid haemorrhage (SAH) Day 18 and was found to have a CBF of 40 cc 100 g-1 min-1 when the pCO2 was 21 Torr and the mean blood pressure (BP) was 99 Torr. The development of vasospasm was correlated with a CBF of less than 40 cc 100 g-1 min-1. Some patients with vasospasm also develop a significant drop in CBF during the period of monitoring. Using these criteria, CBF monitoring predicted the development of vasospasm in seven patients, was compatible with the clinical course in three patients and was misleading in two patients. In the seven patients in which CBF predicted vasospasm, changes were seen in CBF prior to changes observed by clinical examination, transcranial Doppler, and/or angiography.(ABSTRACT TRUNCATED AT 250 WORDS)
对15例颅内动脉瘤患者进行了术后监测。将热扩散血流探头置于感兴趣区域的皮质上，连续记录脑血流量（CBF）1 - 4天。血管痉挛也可通过临床病情恶化、经颅多普勒检测的速度增加以及血管造影显示的血管管径减小来检测。对这些确定血管痉挛的方法与CBF变化进行了比较。3例患者患有未破裂动脉瘤，且无血管痉挛迹象。这些患者的CBF范围为44至100 cc·100 g⁻¹·min⁻¹，每日平均值为78 cc·100 g⁻¹·min⁻¹。1例患者在蛛网膜下腔出血（SAH）第18天出现一段时间的血管痉挛后接受了延迟手术，当动脉血二氧化碳分压（pCO2）为21 Torr且平均血压（BP）为99 Torr时，发现其CBF为40 cc·100 g⁻¹·min⁻¹。血管痉挛的发生与CBF低于40 cc·100 g⁻¹·min⁻¹相关。一些血管痉挛患者在监测期间CBF也会显著下降。根据这些标准，CBF监测在7例患者中预测了血管痉挛的发生，在3例患者中与临床病程相符，在2例患者中产生了误导。在CBF预测血管痉挛的7例患者中，在临床检查、经颅多普勒和/或血管造影观察到变化之前，CBF就出现了变化。（摘要截取自250字）
