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Case Analysis of Persistent Vasospasm after Cerebral Artery Aneurysm Rupture by Using Transcranial Color Coded Doppler Ultrasonography

경두개 색조 도플러 초음파검사를 이용한 대뇌동맥 파열 이후 지속적인 혈관 연축 증례 분석

  • Ji, Myeong-Hoon (Department of Radiological Science, Graduate School of Health Sciences, Cheongju University) ;
  • Seoung, Youl-Hun (Department of Radiological Science, Graduate School of Health Sciences, Cheongju University)
  • 지명훈 (청주대학교 보건의료대학원 방사선학과) ;
  • 성열훈 (청주대학교 보건의료대학원 방사선학과)
  • Received : 2021.02.13
  • Accepted : 2021.02.25
  • Published : 2021.02.28

Abstract

In this case analysis, a patient was diagnosed with subarachnoid hemorrhage (SAH) in a 49-year-old female and showed persistent vasospasm after coil emboilzation in an aneurysm. The patient suffered from persistent vasospasm and performed angioplasty a total of 6 times. Transcranial color coded doppler (TCCD) was performed 12 times to monitor vasospasm. As a result, repetitive cerebral blood flow tests were low cost and safely performed without exposure to invasive radiation through the TCCD, and the repeatability and reproducibility of the test were confirmed with the capabilities of a trained professional radiological technologist.

Keywords

References

  1. Lefkovits J, Davis SM, Rossiter C, Kilpatrick CJ, Hopper JL, Green R, et al. Acute stroke outcome: Effects of stroke type aS. nd risk factors. Australian and New Zealand Journal of Medicine. 1992;22(1): 30-5. https://doi.org/10.1111/j.1445-5994.1992.tb01705.x
  2. Rabinstein AA, Weigand S, Atkinson JL, Wijdicks EF. Patterns of cerebral infarction in aneurysmal subarachnoid hemorrhage. Stroke. 2005;36(5):992-7. https://doi.org/10.1161/01.str.0000163090.59350.5a
  3. Lindbohm JV, Kaprio J, Jousilahti P, Salomaa V, Korja M. Risk factors of sudden death from subarachnoid hemorrhage. Stroke. 2017;48(9):2399-404. https://doi.org/10.1161/STROKEAHA.117.018118
  4. Kassell NF, Sasaki T, Colohan AR, Nazar G. Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke. 1985;16(4):562-72. https://doi.org/10.1161/01.STR.16.4.562
  5. Vora YY, Suarez-Almazor M, Steinke DE, Martin ML, Findlay JM. Role of transcranial Doppler monitoring in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage. Neurosurgery. 1999;44(6): 1237-48. https://doi.org/10.1227/00006123-199906000-00039
  6. Kidwell CS, Chalela JA, Saver JL, Starkman S, Hill MD, Demchuk AM, Warach S. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. Jama. 2004;292(15):1823-30. https://doi.org/10.1001/jama.292.15.1823
  7. Fontanella M, Valfr W, Benech F, Carlino C, Garbossa D, Ferrio M, et al. Vasospasm after SAH due to aneurysm rupture of the anterior circle of Willis: Value of TCD monitoring. Neurological Research. 2008;30(3):256-61. https://doi.org/10.1179/016164107X229939
  8. Sch oning M, Buchholz R, Walter J. Comparative study of transcranial color duplex sonography and transcranial Doppler sonography in adults. Journal of Neurosurgery. 1993;78(5):776-84. https://doi.org/10.3171/jns.1993.78.5.0776
  9. Gonzalez NR, Boscardin WJ, Glenn T, Vinuela F, Martin NA. Vasospasm probability index: A combination of transcranial doppler velocities, cerebral blood flow, and clinical risk factors to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Journal of Neurosurgery. 2007;107(6): 1101-12. https://doi.org/10.3171/JNS-07/12/1101
  10. Kim GW, Sohn YH, Lee JH, Kim DS, Kim JY, et al. The reference values and influencing factors of TCD measurements in 200 normal Korean adults. Journal of the Korean Neurological Association. 1995;13(4):815-24.
  11. Macdonald RL. Management of cerebral vasospasm. Neurosurgical Review. 2006;29(3);179-93. https://doi.org/10.1007/s10143-005-0013-5
  12. Treggiari MM, Walder B, Suter PM, Romand JA. Systematic review of the prevention of delayed ischemic neurological deficits with hypertension, hypervolemia, and hemodilution therapy following subarachnoid hemorrhage. Journal of Neurosurgery. 2003;98(5);978-84. https://doi.org/10.3171/jns.2003.98.5.0978
  13. Suhardja A. Mechanisms of disease: Roles of nitric oxide and endothelin-1 in delayed cerebral vasospasm produced by aneurysmal subarachnoid hemorrhage. Nature Clinical Practice Cardiovascular Medicine. 2004;1(2);110-6. https://doi.org/10.1038/ncpcardio0046
  14. Sen J, Belli A, Albon H, Morgan L, Petzold A, Kitchen N. Triple-H therapy in the management of aneurysmal subarachnoid haemorrhage. The Lancet Neurology. 2003;2(10):614-21. https://doi.org/10.1016/S1474-4422(03)00531-3
  15. Treggiari MM, Walder B, Suter PM, Romand JA. Systematic review of the prevention of delayed ischemic neurological deficits with hypertension, hypervolemia, and hemodilution therapy following subarachnoid hemorrhage. Journal of Neurosurgery. 2003;98(5);978-84. https://doi.org/10.3171/jns.2003.98.5.0978
  16. Higashida RT, Van Halbach V, Dowd CF, Dormandy B, Bell J, Hieshima GB. Intravascular balloon dilatation therapy for intracranial arterial vasospasm: Patient selection, technique, and clinical results. Neurosurgical Review. 1992;15(2):89-95. https://doi.org/10.1007/BF00313501
  17. Rauch F, Schoenau E. Changes in bone density during childhood and adolescence: An approach based on bone's biological organization. Journal of Bone and Mineral Research. 2001;16(4):597-604. https://doi.org/10.1359/jbmr.2001.16.4.597
  18. Warming L, Hassager C, Christiansen C. Changes in bone mineral density with age in men and women: A longitudinal study. Osteoporosis International. 2002;13(2):105-12. https://doi.org/10.1007/s001980200001
  19. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. New England Journal of Medicine. 2001;344(19): 1434-41. https://doi.org/10.1056/NEJM200105103441904
  20. Hoksbergen AWJ, Legemate DA, Ubbink DT, Jacobs MJHM. Success rate of transcranial color-coded duplex ultrasonography in visualizing the basal cerebral arteries in vascular patients over 60 years of age. Stroke. 1999;30(7):1450-5. https://doi.org/10.1161/01.str.30.7.1450
  21. Monteiro LM, Bollen CW, Van Huffelen AC, Ackerstaff RG, Jansen NJ, et al. Transcranial Doppler ultrasonography to confirm brain death: A meta-analysis. Intensive Care Medicine. 2006; 32(12):1937-44. https://doi.org/10.1007/s00134-006-0353-9
  22. Nicoletto HA, Burkman MH. Transcranial Doppler series part III: Interpretation. American Journal of Electroneurodiagnostic Technology. 2009;49(3): 244-59. https://doi.org/10.1080/1086508x.2009.11079725
  23. Alexandrov AV. Cerebrovascular ultrasound in stroke prevention and treatment. 1st ed. Hoboken: Wiley-blackwell; 2004:17-32.
  24. Gonzalez NR, Boscardin WJ, Glenn T, Vinuela F, Martin NA. Vasospasm probability index: A combination of transcranial doppler velocities, cerebral blood flow, and clinical risk factors to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Journal of Neurosurgery. 2007;107(6): 1101-12. https://doi.org/10.3171/JNS-07/12/1101