RELATION BETWEEN MEAN BLOOD PRESSURE (MAP) AND LINDEGAARD RATIO IN PATIENTS UNDERGOING SURGERY FOR A NON-RUPTURE BRAIN ANEURYSM. THE ROLE OF USING CATECHOLAMINES
Keywords:MBP, Lindegaard ratio, Transcranial Doppler ultrasound, cerebrovascular vasospasm
The aim of the study is to analyze and establish the relation between mean arterial pressure (MAP) and cerebral blood supply, respectively, cerebral vasospasm, in patients operated for non-ruptured cerebral aneurysms in the early postoperative period by measuring the Lindegaard ratio.
Materials and methods:
The study included 48 patients operated on non-ruptured brain aneurysms for the period from May 2018. until June 2019. The patients were divided into two groups, depending on the MAP values and the use of catecholamines in the early postoperative period, with the Lindegaard ratio measured by transcranial Doppler ultrasound.
Depending on the values of MP, patients are divided into two groups: MBP 70-90 mm / Hg and 90 mm / Hg. Better brain perfusion was reported in the 90 mm / Hg group with 23.23%, respectively, a lower Lindegaard ratio, despite better results in comparing the two groups of patients, the improvement in cerebral blood flow was not statistically significant, p value < 0.5. Depending on the use of catecholamines in the early postoperative period, we divide patients into two groups: with and without catecholamine . In the catecholamine - treated group, brain perfusion was reported to be better by 32.14%, despite these results, comparing the two groups of patients,
improvement in cerebral blood supply was not statistically significant with p value <0.5.
I. Nehls DG, Flom RA, Carter LP, et al. Multiple Intracranial Aneurysms: Determining the Site of Rupture. J Neurosurg. 1985; 63:342–348
II. Tew JM, Thompson RA, Green JR. In:Guidelines for management and surgical treatment of intracranial Aneurysms. Controversies in Neurology. New York: Raven Press; 1983:139-154
III. Raps EC, Galetta SL, Solomon RA, et al. The Clinical Spectrum of Unruptured Intracranial Aneurysms. Arch Neurol. 1993; 50:265–268
IV. Day JW, Raskin NH. Thunderclap Headache: Symptom of Unruptured Cerebral Aneurysm. Lancet. 1986; 2:1247–1248
V. Verweij RD, Wijdicks EFM, van Gijn J. Warning Headache in Aneurysmal Subarachnoid Hemorrhage: A Case-Control Study. Arch Neurol. 1988; 45:1019–1020
VI. Wirth FP. Surgical treatment of incidental intracranial aneurysms. Clin Neurosurg. 1986; 33:125-135
VII. Maeda K, Kurita H, Nakamura T, et al. Occurrence of Severe Vasospasm Following Intraventricular Hemorrhage from an Arteriovenous Malformation. J Neurosurg. 1997; 87:436–439
VIII. Martin NA, Doberstein C, Zane C, et al. Posttraumatic Cerebral Arterial Spasm: Transcranial Doppler Ultrasound, Cerebral Blood Flow, and Angiographic Findings. J Neurosurg. 1992; 77:575–583
IX. Ecker A, Riemenschneider PA. Arteriographic Demonstration of Spasm of the Intracranial Arteries: With Special Reference to Saccular Aneurysms. JNeurosurg. 1951; 8:660–667
X. Dorsch N. A clinical review of cerebral vasospasm and delayed ischaemia following aneurysm rupture. Acta Neurochir Suppl. 2011; 110:5–6
XI. Leffers AM, Wagner A. Neurologic complications of cerebral angiography: A retrospective study of complication rate and patient risk factors. Acta Radiol 2000;41:204-210.
XII. Aaslid R, Markwalder TM, Nornes H: Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 57:769–774, 1982
XIII. Aaslid R, Huber P, Nornes H: A transcranial Doppler method in the evaluation of cerebrovascular spasm. Neuroradiology 28: 11–16, 1986
XIV. Aaslid R, Huber P, Nornes H: Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. J Neurosurg 60: 37–41, 1984
XV. Grosset DG, Straiton J, McDonald I, Bullock R: Angiographic and Doppler diagnosis of cerebral artery vasospasm following subarachnoid haemorrhage. Br J Neurosurg 7:291–298, 1993
XVI. Seiler RW, Grolimund P, Aaslid R, Huber P, Nornes H: Cerebral vasospasm evaluated by transcranial ultrasound correlated with clinical grade and CT-visualized subarachnoid hemorrhage. J Neurosurg 64:594–600, 1986
XVII. Seiler RW, Grolimund P, Aaslid R, et al. Cerebral Vasospasm Evaluated by Transcranial Ultrasound Correlated with Clinical Grade and CT-Visualized Subarachnoid Hemorrhage. J Neurosurg. 1986; 64:594–600
XVIII. Lindegaard KF, Nornes H, Bakke SJ, et al. Cerebral Vasospasm After Subarachnoid Hemorrhage Investigated by Means of Transcranial Doppler Ultrasound. Acta Neurochir. 1988; 42:81–84
XIX. Sekhar LN, Wechsler LR, Yonas H, et al. Value of Transcranial Doppler Examination in the Diagnosis of Cerebral Vasospasm After Subarachnoid Hemor- rhage. Neurosurgery. 1988; 22:813–821
XX. Creissard P, Proust F, Langlois O: Vasospasm diagnosis: theoretical and real transcranial Doppler sensitivity. Acta Neurochir (Wien) 136:181–185, 1995
XXI. Ekelund A, Saveland H, Romner B, Brandt L: Is transcranial Doppler sonography useful in detecting late cerebral ischaemia after aneurysmal subarachnoid haemorrhage? Br J Neurosurg 10:19–25, 1996
XXII. Mizuno M, Nakajima S, Sampei T, Nishimura H, Hadeishi H, Suzuki A, et al: Serial transcranial Doppler flow velocity and cere- bral blood flow measurements for evaluation of cerebral vasospasm after subarachnoid hemorrhage. Neurol Med Chir (Tokyo) 34:164–171, 1994
XXIII. Malhotra K, Conners JJ, Lee VH, Prabhakaran S. Relative changes in transcranial Doppler velocities are inferior to absolute thresholds in prediction of symptomatic vasospasm after subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2014;23:31–6.
XXIV. Egge A, Waterloo K, Sjoholm H, Solberg T, Inge- brigtsen T, Romner B. Prophylactic hyperdynamic postoperative fluid therapy after aneurysmal sub- arachnoid hemorrhage: a clinical, prospective, randomized, controlled study. Neurosurgery. 2001; 49:593–605; discussion 605-6
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