Continuous Monitoring of Spreading Depolarization and Cerebrovascular Autoregulation after Aneurysmal Subarachnoid Hemorrhage

被引：19

作者：

Sugimoto, Kazutaka ^{[1
]}

Shirao, Satoshi ^{[1
]}

Koizumi, Hiroyasu ^{[1
]}

Inoue, Takao ^{[1
]}

Oka, Fumiaki ^{[1
]}

Maruta, Yuichi ^{[1
]}

Suehiro, Eiichi ^{[1
]}

Sadahiro, Hirokazu ^{[1
]}

Oku, Takayuki ^{[1
]}

Yoneda, Hiroshi ^{[1
]}

Ishihara, Hideyuki ^{[1
]}

Nomura, Sadahiro ^{[1
]}

Suzuki, Michiyasu ^{[1
]}

机构：

[1] Yamaguchi Univ, Sch Med, Dept Neurosurg, 1-1-1 Minami Kogushi, Ube, Yamaguchi 7558505, Japan

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2016年 / 25卷 / 10期

关键词：

Subarachnoid hemorrhage; cortical spreading depolarization; delayed cerebral ischemia; spreading ischemia; vasospasm; cerebrovascular autoregulation; CEREBRAL PERFUSION-PRESSURE; ISCHEMIC NEUROLOGICAL DEFICITS; BRAIN TRAUMA; HEAD-INJURY; DEPRESSION; REACTIVITY; VASOSPASM; CORTEX; CLUSTERS; SPACE;

D O I：

10.1016/j.jstrokecerebrovasdis.2016.07.007

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Delayed cerebral ischemia (DCI) is a prominent complication after aneurysmal subarachnoid hemorrhage (aSAH). Although vasospasm of proximal cerebral arteries has been regarded as the main cause of DCI, vasospasm of distal arteries, microthrombosis, impaired autoregulation, cortical spreading depolarization (CSD), and spreading ischemia are thought to be involved in DCI after aSAH. Here, we describe a patient with aSAH in whom CSD and cerebrovascular autoregulation were evaluated using simultaneous electrocorticography and monitoring of the pressure reactivity index (PRx) after surgical clipping of a ruptured posterior communicating artery aneurysm. In this patient, a prolonged duration of CSD and elevation of PRx preceded delayed neurological deficit. Based on this observation, we propose a relationship between these factors and DCI. Assessment of cerebrovascular autoregulation may permit detection of the inverse hemodynamic response to cortical depolarization. Detection of DCI may be achieved through simultaneous monitoring of CSD and PRx in patients with aSAH.

引用

页码：E171 / E177

页数：7

共 30 条

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