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Serial single-photon emission computed tomographic and transcranial doppler measurements for evaluation of vasospasm after aneurysmal subarachnoid hemorrhage

Egge, A; Sjoholm, H; Waterloo, K; Solberg, T; Ingebrigtsen, T and Romner, Bertil LU (2005) In Neurosurgery 57(2). p.237-248
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 SPELT 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. SPELT findings were significantly associated with transcranial Doppler recordings (P=0.016) and... (More)
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 SPELT 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. SPELT 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 hypoperfusionj 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 (beta=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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hemorrhage, subarachnoid, hemodynamics, single-photon emission computed tomography, vasospasm, transcranial Doppler
in
Neurosurgery
volume
57
issue
2
pages
237 - 248
publisher
Congress of Neurological Surgeons
external identifiers
  • wos:000231111200009
  • pmid:16094151
  • scopus:23244432516
ISSN
0148-396X
DOI
10.1227/01.NEU.0000166538.60333.D6
language
English
LU publication?
yes
id
fdb7ccd1-d032-418b-8666-cabbfa888506 (old id 224837)
alternative location
http://www.neurosurgery-online.com/pt/re/neurosurg/abstract.00006123-200508000-00005.htm;jsessionid=GT2MpV7wjNYWBwFJck9LGGFQxwBq0nqpnB8xX25nj5ThMSpW0vhn!-79285651!181195629!8091!-1
date added to LUP
2007-08-24 13:11:23
date last changed
2017-08-13 04:20:24
@article{fdb7ccd1-d032-418b-8666-cabbfa888506,
  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 SPELT 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. SPELT 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 hypoperfusionj 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 (beta=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.},
  author       = {Egge, A and Sjoholm, H and Waterloo, K and Solberg, T and Ingebrigtsen, T and Romner, Bertil},
  issn         = {0148-396X},
  keyword      = {hemorrhage,subarachnoid,hemodynamics,single-photon emission computed tomography,vasospasm,transcranial Doppler},
  language     = {eng},
  number       = {2},
  pages        = {237--248},
  publisher    = {Congress of Neurological Surgeons},
  series       = {Neurosurgery},
  title        = {Serial single-photon emission computed tomographic and transcranial doppler measurements for evaluation of vasospasm after aneurysmal subarachnoid hemorrhage},
  url          = {http://dx.doi.org/10.1227/01.NEU.0000166538.60333.D6},
  volume       = {57},
  year         = {2005},
}