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Abstract
We studied the incidence and time course of flow velocity changes suggesting a vasospasm
following post-traumatic subarachnoid hemorrhage (SAH) considering the intracranial
pressure (ICP) in 38 SAH patients as compared to 30 patients with spontaneous SAH.
The first investigation was done within 24 h after onset of hemorrhage and regularly
followed up during the clinical course. Additionally, the index of cerebral circulatory
resistance was calculated and the ICP was measured using an epidural transducer. A
significant correlation between middle cerebral artery maximum mean flow velocity
and the quantity of blood seen on a computed tomographic scan in patients with post-traumatic
SAH indicates a similar pathogenetic mechanism of the development of vasospasm to
that after spontaneous SAH. In contrast, there was a significantly earlier occurrence
of mean flow velocities over 120 cm/s following post-traumatic SAH irrespective of
the ICP. Therefore, additional factors must be considered in the evaluation of these
pathologically raised flow velocities after posttraumatic SAH. In both SAH groups
there was a highly significant correlation between clinical outcome and clinical grade
on admission, ICP and resistance index. The weak correlation between maximum mean
flow velocity and clinical outcome following post-traumatic SAH supports the notion
that final clinical outcome of these patients is of multifactorial origin.
Keywords
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Article info
Publication history
Accepted:
April 23,
1993
Received in revised form:
April 8,
1993
Received:
November 27,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.