通过近红外时间分辨光谱法对蛛网膜下腔出血后脑血管痉挛进行床边评估。

Bedside assessment of cerebral vasospasms after subarachnoid hemorrhage by near infrared time-resolved spectroscopy.

机构信息

Division of Neurological Surgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.

出版信息

Adv Exp Med Biol. 2010;662:505-11. doi: 10.1007/978-1-4419-1241-1_73.

DOI:10.1007/978-1-4419-1241-1_73

PMID:20204837

Abstract

We examined the usefulness of near infrared time-resolved spectroscopy (TRS) for detection of vasospasm in subarachnoid hemorrhage (SAH). We investigated seven aneurysmal SAH patients with poor clinical conditions (WFNS grade V) who underwent endovascular coil embolization. Employing TRS, we measured the oxygen saturation (SO(2)) and baseline hemoglobin concentrations in the cortices. Measurements of TRS and transcranial Doppler sonography (TCD) were performed repeatedly for 14 days after SAH. In four of the seven patients, the SO(2) and hemoglobin concentrations measured in the brain tissue of the middle cerebral artery territory remained stable after SAH. However, in three patients, TRS revealed abrupt decreases in SO(2) and total hemoglobin between 5 and 9 days after SAH. Cerebral angiography performed on the same day revealed severe vasospasms in these patients. Although TCD detected the vasospasm in two of three cases, it failed to do so in one case. TRS could detect vasospasms after SAH by evaluating the cortical blood oxygenation.

摘要

我们研究了近红外时间分辨光谱（TRS）在蛛网膜下腔出血（SAH）中检测血管痉挛的有用性。我们研究了 7 名接受血管内线圈栓塞治疗的临床状况较差（WFNS 5 级）的动脉瘤性 SAH 患者。通过 TRS，我们测量了皮质的氧饱和度（SO（2））和基线血红蛋白浓度。在 SAH 后 14 天内，对 TRS 和经颅多普勒超声（TCD）进行了重复测量。在 7 名患者中的 4 名患者中，SAH 后大脑中动脉区域的脑组织中测量的 SO（2）和血红蛋白浓度保持稳定。然而，在 3 名患者中，TRS 在 SAH 后 5 至 9 天内显示 SO（2）和总血红蛋白的突然下降。同日进行的脑血管造影显示这些患者存在严重的血管痉挛。尽管 TCD 在 3 例中的 2 例中检测到了血管痉挛，但在 1 例中未能检测到。TRS 通过评估皮质血氧饱和度可以检测 SAH 后的血管痉挛。