In:
Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 93, No. 6 ( 2000-12), p. 1014-1018
Abstract:
Object. The mechanism of reduction of cerebral circulation and metabolism in patients in the acute stage of aneurysmal subarachnoid hemorrhage (SAH) has not yet been fully clarified. The goal of this study was to elucidate this mechanism further. Methods. The authors estimated cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO 2 ), O 2 extraction fraction (OEF), and cerebral blood volume (CBV) preoperatively in eight patients with aneurysmal SAH (one man and seven women, mean age 63.5 years) within 40 hours of onset by using positron emission tomography (PET). The patients' CBF, CMRO2, and CBF/CBV were significantly lower than those in normal control volunteers. However, OEF and CBV did not differ significantly from those in control volunteers. The significant decrease in CBF/CBV, which indicates reduced cerebral perfusion pressure, was believed to be caused by impaired cerebral circulation due to elevated intracranial pressure (ICP) after rupture of the aneurysm. In two of the eight patients, uncoupling between CBF and CMRO 2 was shown, strongly suggesting the presence of cerebral ischemia. Conclusions. The initial reduction in CBF due to elevated ICP, followed by reduction in CMRO 2 at the time of aneurysm rupture may play a role in the disturbance of CBF and cerebral metabolism in the acute stage of aneurysmal SAH.
Type of Medium:
Online Resource
ISSN:
0022-3085
DOI:
10.3171/jns.2000.93.6.1014
Language:
Unknown
Publisher:
Journal of Neurosurgery Publishing Group (JNSPG)
Publication Date:
2000
detail.hit.zdb_id:
2026156-1
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