THE RELATION OF CEREBRAL VASOSPASM TO THE EXTENT AND LOCATION OF SUBARACHNOID BLOOD VISUALIZED BY CT SCAN - A PROSPECTIVE-STUDY
THE RELATION OF CEREBRAL VASOSPASM TO THE EXTENT AND LOCATION OF SUBARACHNOID BLOOD VISUALIZED BY CT SCAN - A PROSPECTIVE-STUDY
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DOI：
10.1212/wnl.33.4.424
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发表时间：
1983-01-01
期刊：
影响因子：
9.9
通讯作者：
FISHER, CM
中科院分区：
文献类型：
--
作者：
KISTLER, JP;CROWELL, RM;FISHER, CM
在41例经证实的囊状动脉瘤破裂病例中，前瞻性预测是否存在迟发性症状性脑血管痉挛。CT [计算机断层扫描]标准量化蛛网膜下腔血液的范围和位置（在以前的回顾性研究中开发）用于该前瞻性系列患者。患者（22例）具有大于3倍的可识别的蛛网膜下腔凝块。5 mm或厚度超过1 mm的血液层（在复制的图像上测量）。在22例重度显著凝块或厚层患者中，20例患者的重度血管痉挛被正确预测和定位（2例假阳性）。在19例无血或弥漫性血或蛛网膜下腔外有血的患者中，14例正确预测了无严重血管痉挛（5例假阴性）。所有假阳性和假阴性病例均可解释为CT技术不佳。显然，蛛网膜下腔血液的范围和位置决定了血管痉挛的严重程度和位置，现在可以识别出有发生症状性脑血管痉挛危险的患者。现在可以更准确地评估早期预防措施。
In 41 cases of verified ruptured saccular aneurysm, the presence or absence of delayed symptomatic cerebral vasospasm was prospectively predicted. CT [computed tomography] criteria quantifying the extent and location of subarachnoid blood (developed in a previous retrospective study) were used in this prospective series of patients. Patients (22) had recognizable subarachnoid clots larger than 3 .times. 5 mm or layers of blood more than 1 mm thick (measured on reproduced images). In 20 of the 22 patients with severe significant clot or thick layers, severe vasospasm was correctly predicted and localized (2 false positives). In 19 patients with no blood, or diffuse blood or blood outside the subarachnoid space, the absence of severe vasospasm was correctly predicted in 14 (5 false negatives). All of the false-positive and false-negative cases could be explained by inadequate CT technique. Apparently, the extent and location of blood in the subarachnoid space determine the severity and location of vasospasm and that patients in jeopardy of developing symptomatic cerebral vasospasm can now be identified. Early preventive measures may now be assessed more accurately.