Hyperemia following aneurysmal subarachnoid hemorrhage: incidence, diagnosis, clinical features, and outcome

Hyperemia is a known phenomenon after aneurysmal subarachnoid hemorrhage, but only a few reports describe and analyze hyperemia in these patients. This could be the result of diagnostic difficulties in order to identify elevated cerebral blood flow; thus, it seems that hyperemia could be an underdia...

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Bibliographic Details
Published in:Intensive care medicine 2004-07, Vol.30 (7), p.1298-1302
Main Authors: ROTHOERL, Ralf Dirk, WOERTGEN, Chris, BRAWANSKI, Alexander
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Aneurysms
Biological and medical sciences
Blood Flow Velocity
Brain - blood supply
Cerebral Angiography
Doppler effect
Female
Hemorrhage
Humans
Hydrocephalus
Hyperemia - diagnosis
Hyperemia - etiology
Hyperemia - physiopathology
Intensive care
Intensive care medicine
Intensive Care Units
Ischemia
Male
Medical imaging
Medical sciences
Middle Aged
Prognosis
Regional Blood Flow
Retrospective Studies
Subarachnoid Hemorrhage - complications
Tomography, X-Ray Computed
Ultrasonic imaging
Ultrasonography, Doppler, Transcranial
Veins & arteries
Xenon
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Summary:Hyperemia is a known phenomenon after aneurysmal subarachnoid hemorrhage, but only a few reports describe and analyze hyperemia in these patients. This could be the result of diagnostic difficulties in order to identify elevated cerebral blood flow; thus, it seems that hyperemia could be an underdiagnosed clinical state. The aim of the study was to evaluate this phenomenon in comparison with clinical outcome and imaging data in order to describe the frequency of hyperemia after subarachnoid hemorrhage and maybe improve clinical diagnosis. Retrospective analysis of our cerebral blood flow and transcranial Doppler sonography data bank. . Neurosurgical/Anesthesiological intensive care unit University of Regensburg, Regensburg, Germany. A total of 37 patients were included (24 women and 13 men). All patients suffered from aneurysmal subarachnoid hemorrhage. Standard transcranial Doppler ultrasonography, as well as the Xenon(133) clearance technique for cerebral blood flow measurements, was employed. We observed 37 increases of flow velocities in 37 patients according to Doppler ultrasonography. In order to distinguish between ischemia and hyperemia a Xenon(133) regional cerebral blood flow examination was performed. Global hyperemia was detected in 5 patients (14%). Hyperemia correlated only to favorable outcome ( p=0.01) and fewer ischemic lesions in the computed tomography ( p
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-004-2264-y