Hemodynamically significant cerebral vasospasm and outcome after head injury: a prospective study

Publisher Website
Google Scholar
Abstract
✓ The authors prospectively investigated cerebral hemodynamic changes in 152 patients with head injuries to clarify the relationship between cerebral vasospasm and outcome. They also sought to determine the most clinically meaningful criteria for diagnosing cerebral vasospasm. Patients with varying degrees of moderate-to-severe head injury were monitored using transcranial Doppler (TCD) ultrasonography and intravenous 133Xe—cerebral blood flow (CBF) measurements. Outcome was determined at 6 months. Using TCD ultrasonography, mean flow velocities were determined for the middle cerebral artery (VMCA, 149 patients) and basilar artery (VBA, 126 patients). Recordings of the mean extracranial internal carotid artery velocity (VEC-ICA) were also performed to determine the hemispheric ratio (VMCA/VEC-ICA, 147 patients). Cerebral blood flow measurements were obtained in 91 patients. Concurrent TCD and CBF data from 85 patients were used to calculate a “spasm index” (the VMCA or VBA, respectively, divided by the he...