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Serial Single-photon Emission Computed Tomographic and Transcranial Doppler Measurements for Evaluation of Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Authors :
Arild Egge
Tor Ingebrigtsen
Bertil Romner
Tore Solberg
Hans Sjøholm
Knut Waterloo
Source :
Neurosurgery. 57:237-242
Publication Year :
2005
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2005.

Abstract

OBJECTIVE: To assess the clinical value of serial single photon-emission computed tomographic (SPECT) measurements after aneurysmal subarachnoid hemorrhage (SAH). METHODS: Thirty-two patients were studied prospectively during the first 26 days after SAH with repeated SPECT measurements, clinical examinations, and transcranial Doppler recordings. Time trends were analyzed with a general linear model. A final SPECT measurement was performed after 1 year. RESULTS: A mean of 2.6 (range, 1–5) SPECT measurements revealed a significant (P = 0.001) quadratic curve consistent with initial hypoperfusion and then with hyperperfusion during the acute stage. SPECT findings were significantly associated with transcranial Doppler recordings (P = 0.016) and clinical assessments (P = 0.008). Patients fulfilling clinical and transcranial Doppler criteria for vasospasm demonstrated a more pronounced relative hypoperfusion-hyperperfusion time course. A multivariate logistic regression analysis identified SPECT measurements obtained during Days 7 to 14 after the SAH as the only independent predictor (β = 0.042, P = 0.02) for impaired perfusion after 1 year. CONCLUSION: Serial SPECT measurements after aneurysmal SAH demonstrate that regional changes in cerebral perfusion follow a nonlinear time trend, and repeated measurements are necessary. This observation, as well as the low feasibility of SPECT, restricts the clinical value of such measurements.

Details

ISSN :
15244040 and 0148396X
Volume :
57
Database :
OpenAIRE
Journal :
Neurosurgery
Accession number :
edsair.doi.dedup.....90dfb3c5f17865cd5f3d9ca6134f9b09
Full Text :
https://doi.org/10.1227/01.neu.0000166538.60333.d6