Cerebral circulation and metabolism in the acute stage of subarachnoid hemorrhage

被引:51
作者
Hayashi, T
Suzuki, A
Hatazawa, J
Kanno, I
Shirane, R
Yoshimoto, T
Yasui, N
机构
[1] Res Inst Brain & Blood Vessels, Dept Surg Neurol, Akita 0100874, Japan
[2] Res Inst Brain & Blood Vessels, Dept Radiol, Akita, Japan
[3] Tohoku Univ, Sch Med, Dept Neurosurg, Sendai, Miyagi 980, Japan
关键词
subarachnoid hemorrhage; cerebral aneurysm; cerebral metabolism; positron emission tomography;
D O I
10.3171/jns.2000.93.6.1014
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. The mechanism of reduction of cerebral circulation and metabolism in patients in the acute stage of aneurysmal subarachnoid hemorrhage (SAH) has not yet been fully clarified. The goal of this study was to elucidate this mechanism further. Methods. The authors estimated cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), O-2 extraction fraction (OEF), and cerebral blood volume (CBV) preoperatively in eight patients with aneurysmal SAH tone man and seven women, mean age 63.5 years) within 40 hours of onset by using positron emission tomography (PET). The patients' CBF, CMRO2, and CBF/CBV were significantly lower than those in normal control volunteers. However, OEF and CBV did not differ significantly from those in control volunteers. The significant decrease in CBF/CBV, which indicates reduced cerebral perfusion pressure, was believed to be caused by impaired cerebral circulation due to elevated intracranial pressure (ICP) after rupture of the aneurysm. In two of the eight patients, uncoupling between CBF and CMRO2 was shown, strongly suggesting the presence of cerebral ischemia. Conclusions. The initial reduction in CBF due to elevated ICP, followed by reduction in CMRO2 at the time of aneurysm rupture may play a role in the disturbance of CBF and cerebral metabolism in the acute stage of aneurysmal SAH.
引用
收藏
页码:1014 / 1018
页数:5
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