This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Davis, S. M. Articles by Hopper, J. Search for Related Content PubMed PubMed Citation Articles by Davis, S. M. Articles by Hopper, J.

Stroke, Vol 23, 492-497, Copyright © 1992 by American Heart Association

ARTICLES

Correlations between cerebral arterial velocities, blood flow, and delayed ischemia after subarachnoid hemorrhage

SM Davis, JT Andrews, M Lichtenstein, SC Rossiter, AH Kaye and J Hopper
University Departments of Medicine, Royal Melbourne Hospital, Victoria, Australia.

BACKGROUND AND PURPOSE: Elevated middle cerebral erythrocyte velocities and tissue hypoperfusion have been correlated with delayed ischemia after subarachnoid hemorrhage, but few studies have compared serial arterial velocities with cerebral blood flow and neurological deficits. METHODS: Serial measurements of middle cerebral velocities, using transcranial Doppler ultrasonography, were performed in 34 patients after subarachnoid hemorrhage and correlated with cerebral blood flow, measured in 20 of the 34 using single-photon emission computed tomography with technetium-99m hexamethylpropylene amine oxime and neurological evidence of delayed ischemia. RESULTS: In 16 patients without delayed ischemia, eight had evidence of vasospasm (greater than 120 cm/sec), but only one of seven had hypoperfusion, suggesting that vasospasm might be more common than hypoperfusion in this group (p = 0.1). In 10 patients with delayed ischemia and a lateralizing deficit, both asymmetrical middle cerebral vasospasm (eight of nine with vasospasm) and hypoperfusion (six of six studied) were concordant with the clinically ischemic hemisphere (p less than 0.05). Vasospasm occurred with nonlateralized delayed ischemia in seven of eight patients and with hypoperfusion in five of six, affecting the anterior cerebral territory in three. CONCLUSIONS: Concordant vasospasm and hypoperfusion were most often present in patients with delayed ischemia and lateralizing neurological deficits. Discordant results reflect inherent limitations and the different levels of the circulation monitored by the two techniques.

This article has been cited by other articles:

				J. B. Springborg, H.-J. Frederiksen, V. Eskesen, and N. V. Olsen Trends in monitoring patients with aneurysmal subarachnoid haemorrhage Br. J. Anaesth., March 1, 2005; 94(3): 259 - 270. [Abstract] [Full Text] [PDF]

				G. E. Sviri, D. H. Lewis, R. Correa, G. W. Britz, C. M. Douville, and D. W. Newell Basilar Artery Vasospasm and Delayed Posterior Circulation Ischemia After Aneurysmal Subarachnoid Hemorrhage Stroke, August 1, 2004; 35(8): 1867 - 1872. [Abstract] [Full Text] [PDF]

				R. E. Latchaw, H. Yonas, G. J. Hunter, W. T.C. Yuh, T. Ueda, A. G. Sorensen, J. L. Sunshine, J. Biller, L. Wechsler, R. Higashida, et al. Guidelines and Recommendations for Perfusion Imaging in Cerebral Ischemia: A Scientific Statement for Healthcare Professionals by the Writing Group on Perfusion Imaging, From the Council on Cardiovascular Radiology of the American Heart Association Stroke, April 1, 2003; 34(4): 1084 - 1104. [Full Text] [PDF]

				M. J. Kaufman, J. M. Levin, M. H. Ross, N. Lange, S. L. Rose, T. J. Kukes, J. H. Mendelson, S. E. Lukas, B. M. Cohen, and P. F. Renshaw Cocaine-Induced Cerebral Vasoconstriction Detected in Humans With Magnetic Resonance Angiography JAMA, February 4, 1998; 279(5): 376 - 380. [Abstract] [Full Text] [PDF]

				A. Ekelund, H. Saveland, B. Romner, and L. Brandt Transcranial Doppler Ultrasound in Hypertensive Versus Normotensive Patients After Aneurysmal Subarachnoid Hemorrhage Stroke, November 1, 1995; 26(11): 2071 - 2074. [Abstract] [Full Text]