Ekelund A, Kongstad P, Säveland H, Romner B, Reinstrup P, Kristiansson K A, Brandt L
Department of Neurosurgery, University Hospital, Lund, Sweden.
Acta Neurochir (Wien). 1998;140(10):1029-35; discussion 1035-6. doi: 10.1007/s007010050211.
Noninvasive methods for detecting cerebral artery vasospasm, still a serious complication following aneurysmal subarachnoid haemorrhage, are of vital interest. Up-to-date transcranial Doppler ultrasound (TCD) has proved to be sensitive in detecting vasospasm in the middle cerebral artery, but has less accuracy for other cerebral arteries. Transcranial cerebral oximetry (TCCO) is a new non-invasive technique which may increase the reliability for detecting cerebral ischaemia. The purpose of the present study was to evaluate a putative correlation between TCCO and TCD. We examined the two hemispheres in 14 patients with the aim of evaluating a proposed correlation between TCD and TCCO. Analysis of all absolute values (maximum TCD mFV and minimum TCCO saturation, respectively) in all series indicate a correlation between TCCO and TCD, p < 0.01, r = -0.62. All patients with TCD mean flow velocity > 120 cm/s also presented TCCO saturation < 60%. Conversely, all patients with normal TCCO saturation (> or = 63%) presented normal or moderately increased TCD velocities. In clinical neurosurgical practice it is of great interest if a true correlation between TCD and TCCO exists. The present results support the assumption that TCCO may enhance the reliability for detecting cerebral ischaemia after aneurysmal subarachnoid haemorrhage.
检测脑动脉血管痉挛的非侵入性方法仍然是动脉瘤性蛛网膜下腔出血后的一个严重并发症,备受关注。最新的经颅多普勒超声(TCD)已被证明在检测大脑中动脉血管痉挛方面很敏感,但对其他脑动脉的准确性较低。经颅脑血氧饱和度测定(TCCO)是一种新的非侵入性技术,可能会提高检测脑缺血的可靠性。本研究的目的是评估TCCO与TCD之间的假定相关性。我们检查了14例患者的两个半球,旨在评估TCD与TCCO之间的拟议相关性。对所有系列中的所有绝对值(分别为最大TCD平均血流速度和最小TCCO饱和度)进行分析表明,TCCO与TCD之间存在相关性,p < 0.01,r = -0.62。所有TCD平均流速> 120 cm/s的患者也表现出TCCO饱和度< 60%。相反,所有TCCO饱和度正常(>或= 63%)的患者TCD速度正常或中度增加。在临床神经外科实践中,如果TCD与TCCO之间存在真正的相关性,将非常有意义。目前的结果支持这样一种假设,即TCCO可能会提高动脉瘤性蛛网膜下腔出血后检测脑缺血的可靠性。