Arshi Baback, Mack William J, Emanuel Benjamin
Department of Neurology, University of Southern California, Health Sciences Campus, CHP 209 D, Mail Code 9207, Los Angeles, CA 90089-9207, USA.
Neurol Res Int. 2013;2013:987934. doi: 10.1155/2013/987934. Epub 2013 Mar 31.
Delayed-cerebral ischemia is a major cause of morbidity and mortality in the setting of aneurysmal subarachnoid hemorrhage. Despite extensive research efforts and a breadth of collective clinical experience, accurate diagnosis of vasospasm remains difficult, and effective treatment options are limited. Classically, diagnosis has focused on imaging assessment of the cerebral vasculature. Recently, invasive and noninvasive bedside techniques designed to characterize relevant hemodynamic and metabolic alterations have gained substantial attention. Such modalities include microdialysis, brain tissue oxygenation, jugular bulb oximetry, thermal diffusion cerebral blood flow, and near-infrared spectroscopy. This paper reviews these modalities and examines data pertinent to the diagnosis and management of cerebral vasospasm.
迟发性脑缺血是动脉瘤性蛛网膜下腔出血患者发病和死亡的主要原因。尽管进行了广泛的研究并积累了丰富的临床经验，但准确诊断血管痉挛仍然困难，有效的治疗选择也有限。传统上，诊断主要集中在对脑血管系统的影像学评估上。最近，旨在表征相关血流动力学和代谢改变的有创和无创床边技术受到了广泛关注。这些方法包括微透析、脑组织氧合、颈静脉球血氧饱和度测定、热扩散脑血流量测定和近红外光谱分析。本文综述了这些方法，并研究了与脑血管痉挛诊断和管理相关的数据。
