Mountz J M, McGillicuddy J E, Wilson M W, Bartold S P, Siegal E M
University of Michigan Medical Center, Division of Nuclear Medicine, Ann Arbor.
Acta Neurochir (Wien). 1991;109(1-2):30-3. doi: 10.1007/BF01405693.
Assessment of cerebral perfusion on patients with subarachnoid haemorrhage (SAH) in the Neurologic Intensive Care Unit is difficult since nuclear medicine imaging modalities capable of measuring cerebral blood flow (CBF) are not generally available. We performed 101 quantitative (ml 100g-min) bedside CBF measurements on 40 individual patients to correlate SAH grade with CBF and to assess the effect of surgical intervention on CBF. Global CBF (G-CBF) and bihemispheric CBF (B-CBF) asymmetry were correlated with the grade of SAH pre- and post-operatively. Data analysis showed that pre-operative patients with low grade SAH (Hunt and Hess grades 0 to 2) had higher mean G-CBF values [44.2 +/- 71] than those with high grade SAH (Hunt and Hess grades 3 to 4): [mean G-CBF = 34.1 +/- 1.7]. Post-surgery there was a significant improvement in G-CBF; CBF increased [5.3 +/- 1.07] in the group of patients with low grade SAH. Patients with high grade SAH showed no significant improvement in their G-CBF during the first week post-operatively compared to pre-operative values. We conclude that portable units capable of measuring bedside CBF values are useful in monitoring CBF changes in patients with SAH. Patients with low grade SAH have G-CBF within normal limits both pre-operatively and post-operatively, with a statistically significant increase in CBF during two weeks post-operatively. Patients with high grade SAH show no significant increase in CBF one week post-operatively compared to their pre-operative measures.
在神经重症监护病房中，对蛛网膜下腔出血（SAH）患者进行脑灌注评估很困难，因为通常无法获得能够测量脑血流量（CBF）的核医学成像方式。我们对40例个体患者进行了101次定量（ml/100g·min）床边CBF测量，以关联SAH分级与CBF，并评估手术干预对CBF的影响。术前和术后，全脑CBF（G-CBF）和双侧半球CBF（B-CBF）不对称性均与SAH分级相关。数据分析表明，术前低分级SAH（Hunt和Hess分级0至2级）患者的平均G-CBF值[44.2±7.1]高于高分级SAH（Hunt和Hess分级3至4级）患者：[平均G-CBF = 34.1±1.7]。手术后，G-CBF有显著改善；低分级SAH患者组的CBF增加了[5.3±1.07]。与术前值相比，高分级SAH患者术后第一周的G-CBF没有显著改善。我们得出结论，能够测量床边CBF值的便携式设备有助于监测SAH患者的CBF变化。低分级SAH患者术前和术后的G-CBF均在正常范围内，术后两周内CBF有统计学意义的增加。与术前测量值相比，高分级SAH患者术后一周的CBF没有显著增加。
