Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage can be evaluated using clinical assessment, non-invasive and invasive techniques. An electronic literature search was conducted on English-language articles investigating DCI in human subjects with subarachnoid hemorrhage.Atotal of 31 relevant papers were identified evaluating the role of clinical assessment, transcranial Doppler, computed tomographic angiography, and computed tomographic perfusion. Clinical assessment by bedside evaluations is limited, especially in patients initially in poorer clinical condition or who are receiving sedative medication for whom deterioration may be more difficult to identify. Transcranial Doppler is a useful screening tool for middle cerebral artery vasospasm, with less utility in evaluating other intracranial vessels. Computed tomographic angiography correlates well with digital subtraction angiography. Computed tomographic perfusion may help predict DCI when used early or identify DCI when used later.

Detection and monitoring of vasospasm and delayed cerebral ischemia : a review and assessment of the literature / C.W. Washington, G.J. Zipfel, M.N. Diringer, T.P. Bleck, N. Bruder, E.S. Connolly Jr, G. Citerio, D. Gress, D. Hanggi, J.C. Hemphill, B. Hoh, G. Lanzino, P. Le Roux, D. Menon, A. Rabinstein, E. Schmutzhard, L. Shutter, N. Stocchetti, J. Suarez, M. Treggiari, M.Y. Tseng, M. Vergouwen, P. Vespa, S. Wolf. - In: NEUROCRITICAL CARE. - ISSN 1541-6933. - 15:2(2011 Oct), pp. 312-317. [10.1007/s12028-011-9594-8]

Detection and monitoring of vasospasm and delayed cerebral ischemia : a review and assessment of the literature

N. Stocchetti;
2011

Abstract

Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage can be evaluated using clinical assessment, non-invasive and invasive techniques. An electronic literature search was conducted on English-language articles investigating DCI in human subjects with subarachnoid hemorrhage.Atotal of 31 relevant papers were identified evaluating the role of clinical assessment, transcranial Doppler, computed tomographic angiography, and computed tomographic perfusion. Clinical assessment by bedside evaluations is limited, especially in patients initially in poorer clinical condition or who are receiving sedative medication for whom deterioration may be more difficult to identify. Transcranial Doppler is a useful screening tool for middle cerebral artery vasospasm, with less utility in evaluating other intracranial vessels. Computed tomographic angiography correlates well with digital subtraction angiography. Computed tomographic perfusion may help predict DCI when used early or identify DCI when used later.
Angiography; Cerebral blood flow; Perfusion; Transcranial Doppler; Vasospasm
Settore MED/41 - Anestesiologia
Settore MED/05 - Patologia Clinica
ott-2011
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/169580
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