Stroke with subarachnoid hemorrhage

Assessment of cerebrovascular pressure regulation and simulated cerebrovascular resistance

Michael L. Daley, Nithya Narayanan, Charles Leffler, Per Kristian Eide

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Citations (Scopus)

Abstract

Background Monitoring methods designed to assess cerebrovascular regulation and increased cerebrovascular resistance (CVR) of patients with subarachnoid hemorrhage (SAH) would facilitate therapeutic intervention and potentially reduce secondary complications. The aim of this study was to assess changes of cerebrovascular regulation and CVR by evaluating changes of cerebrovascular pressure transmission in patients with SAH. Methods Admission Hunt-Hess grades, Fisher scores, Glasgow Outcome Scores (GOS) at 6 months, and pressure recordings were obtained from 20 patients. Biomechanical models of cerebrovascular pressure transmission were constructed over one-minute intervals for the initial and final two hours of post-hemorrhage monitoring. Findings Classified according to the GOS score at 6 months, eight patients died (GOS 1), five were severely disabled (GOS 3), and seven patients were moderately disabled (GOS 4). During the initial monitoring period 100%, 80%, and 28.6% of groups with GOS 1, 3, and 4 demonstrated impairment of cerebrovascular regulation; whereas, in the final monitoring period 100%, 100%, and 14.3% respectively demonstrated impairment. Between monitoring periods, simulated CVR (sCVR) significantly increased (p>0.001) for patients with GOS 1 and 3 and decreased for those with GOS 4 with mean resistance for the latter group significantly lower (p>0.001) than other means. Conclusions Loss of cerebrovascular regulation and increased sCVR were observed in SAH patients with poor outcome.

Original languageEnglish (US)
Title of host publicationIntracranial Pressure and Brain Monitoring XIII
Subtitle of host publicationMechanisms and Treatment
PublisherSpringer-Verlag Wien
Pages321-325
Number of pages5
Edition102
ISBN (Print)9783211855775
DOIs
StatePublished - Jan 1 2008

Publication series

NameActa Neurochirurgica, Supplementum
Number102
ISSN (Print)0065-1419

Fingerprint

Subarachnoid Hemorrhage
Stroke
Pressure
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Daley, M. L., Narayanan, N., Leffler, C., & Eide, P. K. (2008). Stroke with subarachnoid hemorrhage: Assessment of cerebrovascular pressure regulation and simulated cerebrovascular resistance. In Intracranial Pressure and Brain Monitoring XIII: Mechanisms and Treatment (102 ed., pp. 321-325). (Acta Neurochirurgica, Supplementum; No. 102). Springer-Verlag Wien. https://doi.org/10.1007/978-3-211-85578-2_61

Stroke with subarachnoid hemorrhage : Assessment of cerebrovascular pressure regulation and simulated cerebrovascular resistance. / Daley, Michael L.; Narayanan, Nithya; Leffler, Charles; Eide, Per Kristian.

Intracranial Pressure and Brain Monitoring XIII: Mechanisms and Treatment. 102. ed. Springer-Verlag Wien, 2008. p. 321-325 (Acta Neurochirurgica, Supplementum; No. 102).

Research output: Chapter in Book/Report/Conference proceedingChapter

Daley, ML, Narayanan, N, Leffler, C & Eide, PK 2008, Stroke with subarachnoid hemorrhage: Assessment of cerebrovascular pressure regulation and simulated cerebrovascular resistance. in Intracranial Pressure and Brain Monitoring XIII: Mechanisms and Treatment. 102 edn, Acta Neurochirurgica, Supplementum, no. 102, Springer-Verlag Wien, pp. 321-325. https://doi.org/10.1007/978-3-211-85578-2_61
Daley ML, Narayanan N, Leffler C, Eide PK. Stroke with subarachnoid hemorrhage: Assessment of cerebrovascular pressure regulation and simulated cerebrovascular resistance. In Intracranial Pressure and Brain Monitoring XIII: Mechanisms and Treatment. 102 ed. Springer-Verlag Wien. 2008. p. 321-325. (Acta Neurochirurgica, Supplementum; 102). https://doi.org/10.1007/978-3-211-85578-2_61
Daley, Michael L. ; Narayanan, Nithya ; Leffler, Charles ; Eide, Per Kristian. / Stroke with subarachnoid hemorrhage : Assessment of cerebrovascular pressure regulation and simulated cerebrovascular resistance. Intracranial Pressure and Brain Monitoring XIII: Mechanisms and Treatment. 102. ed. Springer-Verlag Wien, 2008. pp. 321-325 (Acta Neurochirurgica, Supplementum; 102).
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