Basilar Artery Vasospasm and Delayed Posterior Circulation Ischemia After Aneurysmal Subarachnoid Hemorrhage

Sviri, Gill E.; Lewis, David H.; Correa, Reinaldo; Britz, Gavin W.; Douville, Colleen; Newell, David W.

doi:10.1161/01.str.0000133397.44528.f8

Cited by 53 publications

(31 citation statements)

References 20 publications

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“…Involvement of the cerebellum in ischemic lesions secondary to DCI has been described in a few studies [29][30][31], affecting up to 20% of patients [32]. However, DTI changes observed the cerebellum of patients with SAH do not appear to be related the location of the ruptured aneurysm and more probably reflect a global parenchymal insult.…”

Section: Discussionmentioning

confidence: 96%

Evolution of diffusion tensor imaging parameters after acute subarachnoid haemorrhage: a prospective cohort study

et al. 2016

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Introduction Few studies assessed diffusion tensor imaging (DTI) changes in the acute phase of subarachnoid haemorrhage (SAH). We prospectively evaluated DTI parameters in the acute phase of SAH and 8-10 days after and analysed whether changes could be related to SAH severity or to the development of delayed cerebral ischemia (DCI). Methods Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) changes over time were assessed in a prospective cohort of patients with acute SAH. Two MRI studies were performed at <72 h (MRI-1) and 8-10 days (MRI-2). DTI parameters were recorded in 15 ROIs. Linear mixed regression models were used.

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Section: Discussionmentioning

confidence: 96%

Evolution of diffusion tensor imaging parameters after acute subarachnoid haemorrhage: a prospective cohort study

et al. 2016

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“…No radionuclide test, including HMPAO-SPECT, is known to diagnose brainstem death in isolation. 6,8,55 High resolution HMPAO-SPECT may be capable of defining brainstem blood flow, 56 but larger numbers of cases would be required to validate this test. In a recent review, it was found that for clinically confirmed BD the specificity of HMPAO-SPECT was 12/12 (100%) (95% CI 78.4-100%), and for contrast angiography confirmed BD the specificity of HMPAO-SPECT could not be estimated, as there were no patients without clinical BD having both tests.…”

Section: Discussionmentioning

confidence: 99%

Brain death and the cervical spinal cord: a confounding factor for the clinical examination

2009

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Study design: This study is a systematic review. Objectives: Brain death (BD) is a clinical diagnosis, made by documenting absent brainstem functions, including unresponsive coma and apnea. Cervical spinal cord dysfunction would confound clinical diagnosis of BD. Our objective was to determine whether cervical spinal cord dysfunction is common in BD. Methods: A case of BD showing cervical cord compression on magnetic resonance imaging prompted a literature review from 1965 to 2008 for any reports of cervical spinal cord injury associated with brain herniation or BD. Results: A total of 12 cases of brain herniation in meningitis occurred shortly after a lumbar puncture with acute respiratory arrest and quadriplegia. In total, nine cases of acute brain herniation from various non-meningitis causes resulted in acute quadriplegia. The cases suggest that direct compression of the cervical spinal cord, or the anterior spinal arteries during cerebellar tonsillar herniation cause ischemic injury to the cord. No case series of brain herniation specifically mentioned spinal cord injury, but many survivors had severe disability including spastic limbs. Only two pathological series of BD examined the spinal cord; 56-100% of cases had upper cervical spinal cord damage, suggesting infarction from direct compression of the cord or its arterial blood supply. Conclusions: Upper cervical spinal cord injury may be common after brain herniation. Cervical spinal cord injury must either be ruled out before clinical testing for BD, or an ancillary test to document lack of brainstem blood flow is required in all cases of suspected BD. BD may not be a purely clinical diagnosis.

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“…Una proporción de 2,5 corresponde a un vasoespasmo moderado, mayor de 3 a un vasoespasmo severo y se asocian a una sensibilidad del 100% y una especifi dad del 90% 8,9 .…”

Section: Vasoespasmo De La Circulación Posteriorunclassified

“…La combinación de niveles de vfm mayor de 85 cm/segundos en algún punto de la basilar, y el índice de proporción para la circulación posterior mayor de 3 tienen una sensibilidad superior al 97%, y es criterio de vasoespasmo severo en ese segmento arterial 8 .…”

Section: Vasoespasmo De La Circulación Posteriorunclassified

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Utilidad del doppler transcraneal en la hemorragia subaracnoidea: Revisión

Scherle-Matamoros

Pérez-Nellar

2011

Rev. chil. neuro-psiquiatr.

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This review summarizes the usefulness of transcranial Doppler (TCD) ARTÍCULO DE REVISIÓN IntoducciónL a idea de estudiar la circulación intracraneal con ultrasonido fue inicialmente propuesta en 1960 por Kaneko en Osaka 1 . Hasta ese momento el cráneo se consideraba una barrera infranqueable para el ultrasonido y sólo había sido estudiado el estado de la circulación cerebral con métodos invasivos. En 1965 Miyazaki y Kato utilizaron por primera vez caudalímetros direccionales ultrasónicos basados en el empleo del efecto Doppler para el estudio de las arterias carótidas, y desde ese momento comienza a utilizarse el ultrasonido de forma rutinaria para el estudio de los vasos extracraneales, mientras los vasos intracraneales sólo habían sido abordados en el curso de intervenciones quirúrgicas o en niños con fontanelas abiertas ya que el hueso de los adultos atenuaba excesivamente las ondas de los aparatos diagnósticos, que operaban a frecuencias de 5 a 10 MHz 2 .En 1982, Rune Aslid se percata de que el problema de penetrar el ultrasonido dentro del cráneo podía resolverse utilizando una menor frecuencia de ultrasonido y aprovechando áreas del cráneo donde el hueso fuera más fi no. De esta forma, utilizando una probeta de 2 MHz y un equipo designado originalmente para uso cardíaco introduce en la práctica clínica el Doppler transcraneal (DTC) 3 . Dos años después de haber descrito en sujetos normales las características del fl ujo sanguíneo en los segmentos proximales de los vasos que conforman el polígono de Willis, comenzó a aplicarlo en el diagnóstico y seguimiento del vasoespasmo en la HSA 4 .En poco tiempo, impulsado por su naturaleza no invasiva y la ventaja de poder realizarse junto al enfermo, el DTC comienza a ser introducido en la evaluación de otras afecciones cerebrovasculares 5 .Hasta el año 1994, las investigaciones se concentraron en el vasoespasmo de la circulación anterior REV CHIL NEURO-PSIQUIAT 2011; 49 (1): 79-85

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Basilar Artery Vasospasm and Delayed Posterior Circulation Ischemia After Aneurysmal Subarachnoid Hemorrhage

Cited by 53 publications

References 20 publications

Evolution of diffusion tensor imaging parameters after acute subarachnoid haemorrhage: a prospective cohort study

Evolution of diffusion tensor imaging parameters after acute subarachnoid haemorrhage: a prospective cohort study

Brain death and the cervical spinal cord: a confounding factor for the clinical examination

Utilidad del doppler transcraneal en la hemorragia subaracnoidea: Revisión

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