Time course of vasospasm in man

Restricted access

✓ Measurements were made at eight predetermined positions on 627 sets of angiograms from 293 patients with aneurysms. A ratio between the sum of the vessel diameters in the subarachnoid space to the sum in the base of skull and neck was calculated and plotted against time. Vasospasm has its onset in man about Day 3 after subarachnoid hemorrhage, is maximal at Days 6 to 8, and is gone by Day 12. There is a tendency for patients in poor clinical grades to have more vasospasm. The patients with most vasospasm have a significantly higher mortality than those with the least.

Article Information

Address reprint requests to: Bryce Weir, M.D., Division of Neurosurgery, University of Alberta, Edmonton, Alberta T6G 2G3, Canada.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Positions for measurements of arteries with a method of calculating ratio of vessel diameters in the subarachnoid space to vessel diameters of the internal carotid artery outside the subarachnoid space. M = middle cerebral; A = anterior cerebral; C = internal carotid on anteroposterior view; C1 = internal carotid distal to origin posterior communicating; C2 = internal carotid just proximal to posterior communicating; C3 = internal carotid at level of tuberculum sellae; C5 = internal carotid proximal to cavernous sinus; C6 = internal carotid artery at level of the atlas on lateral film.

  • View in gallery

    Curve for the reduction in ratio of the caliber of vessels in the subarachnoid space to those outside versus time. Based on data from 429 angiograms done post-hemorrhage and preoperatively, there is more constriction in 120 angiograms on patients who died (broken line) than in 309 on survivors (continous line).

  • View in gallery

    Curve for the reduction in ratio of the caliber of vessels in the subarachnoid space to those outside versus time. Based on data from 151 angiograms carried out postoperatively, 123 on survivors (continuous line) and 28 on those who died (broken line).

References

  • 1.

    Allcock JMDrake CG: Ruptured intracranial aneurysms — the role of arterial spasm. J Neurosurg 22:21291965Allcock JM Drake CG: Ruptured intracranial aneurysms — the role of arterial spasm. J Neurosurg 22:21–29 1965

    • Search Google Scholar
    • Export Citation
  • 2.

    Burton AC: Physiology and Biophysics of the Circulation: An Introductory Texted 2. Chicago: Year Book Medical Publishers1972 pp 40Burton AC: Physiology and Biophysics of the Circulation: An Introductory Text ed 2. Chicago: Year Book Medical Publishers 1972 pp 40

    • Search Google Scholar
    • Export Citation
  • 3.

    Bergvall UGalera R: Time relationship between subarachnoid haemorrhage, arterial spasm, changes in cerebral circulation and posthaemorrhagic hydrocephalus. Acta Radiol (Diagn) 9:2292371969Bergvall U Galera R: Time relationship between subarachnoid haemorrhage arterial spasm changes in cerebral circulation and posthaemorrhagic hydrocephalus. Acta Radiol (Diagn) 9:229–237 1969

    • Search Google Scholar
    • Export Citation
  • 4.

    Bergvall USteiner LForster DMC: Early pattern of cerebral circulatory disturbances following subarachnoid haemorrhage. Neuroradiology 5:24321973Bergvall U Steiner L Forster DMC: Early pattern of cerebral circulatory disturbances following subarachnoid haemorrhage. Neuroradiology 5:24–32 1973

    • Search Google Scholar
    • Export Citation
  • 5.

    Drake CG: Formal discussion on Symon L: Vasospasm in aneurysm in: Moossy JJaneway R (eds): Cerebrovascular Diseases Seventh Conference. New York: Grune and Stratton1971 pp 241244Drake CG: Formal discussion on Symon L: Vasospasm in aneurysm in: Moossy J Janeway R (eds): Cerebrovascular Diseases Seventh Conference. New York: Grune and Stratton 1971 pp 241–244

    • Search Google Scholar
    • Export Citation
  • 6.

    Drake CG: Intracranial aneurysms in Tower D (ed): The Nervous System. Volume 2: The Clinical Neurosciences. New York: Raven Press1975 pp 287295Drake CG: Intracranial aneurysms in Tower D (ed): The Nervous System. Volume 2: The Clinical Neurosciences. New York: Raven Press 1975 pp 287–295

    • Search Google Scholar
    • Export Citation
  • 7.

    du Boulay G: Distribution of spasm in the intracranial arteries after subarachnoid haemorrhage. Acta Radiol (Diagn) 1:2572661963du Boulay G: Distribution of spasm in the intracranial arteries after subarachnoid haemorrhage. Acta Radiol (Diagn) 1:257–266 1963

    • Search Google Scholar
    • Export Citation
  • 8.

    Fletcher TMTaveras JMPool JL: Cerebral vasospasm in angiography for intracranial aneurysms. Arch Neurol 1:38471959Fletcher TM Taveras JM Pool JL: Cerebral vasospasm in angiography for intracranial aneurysms. Arch Neurol 1:38–47 1959

    • Search Google Scholar
    • Export Citation
  • 9.

    Gabrielsen TOGreitz T: Normal size of the internal carotid, middle cerebral and anterior cerebral arteries. Acta Radiol (Diagn) 10:1101970Gabrielsen TO Greitz T: Normal size of the internal carotid middle cerebral and anterior cerebral arteries. Acta Radiol (Diagn) 10:1–10 1970

    • Search Google Scholar
    • Export Citation
  • 10.

    Graf CJNibbelink DW: Cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Report on a randomized treatment study. III. Intracranial surgery. Stroke 5:5596011974Graf CJ Nibbelink DW: Cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Report on a randomized treatment study. III. Intracranial surgery. Stroke 5:559–601 1974

    • Search Google Scholar
    • Export Citation
  • 11.

    Grubb RL JrRaichle MEEichling JOet al: Effects of subarachnoid hemorrhage on cerebral blood volume, blood flow, and oxygen utilization in humans. J Neurosurg 46:4464531977Kågström E Greitz T Hanson J et al: Changes in cerebral blood flow after subarachnoid haemorrhage. Proceedings of the Third International Congress of Neurological Surgery 1965. Amsterdam: Excerpta Medica International Congress Series No. 110 1966 pp 629–633

    • Search Google Scholar
    • Export Citation
  • 12.

    Kågström EGreitz THanson Jet al: Changes in cerebral blood flow after subarachnoid haemorrhage. Proceedings of the Third International Congress of Neurological Surgery1965. Amsterdam: Excerpta Medica, International Congress Series No. 1101966 pp 629633Kågström E Greitz T Hanson J et al: Changes in cerebral blood flow after subarachnoid haemorrhage. Proceedings of the Third International Congress of Neurological Surgery 1965. Amsterdam: Excerpta Medica International Congress Series No. 110 1966 pp 629–633

    • Export Citation
  • 13.

    Marshall WH Jr: Delayed arterial spasm following subarachnoid hemorrhage. Radiology 106:3253271973Marshall WH Jr: Delayed arterial spasm following subarachnoid hemorrhage. Radiology 106:325–327 1973

    • Search Google Scholar
    • Export Citation
  • 14.

    Maspes PEMarini G: Intracranial arterial spasm related to supraclinoid ruptured aneurysms. Acta Neurochir 10:6306381962Maspes PE Marini G: Intracranial arterial spasm related to supraclinoid ruptured aneurysms. Acta Neurochir 10:630–638 1962

    • Search Google Scholar
    • Export Citation
  • 15.

    Odom GL: Cerebral vasospasm. Clin Neurosurg 22:29581975Odom GL: Cerebral vasospasm. Clin Neurosurg 22:29–58 1975

  • 16.

    Sahs ALPerret GELocksley HBet al: Intracranial Aneurysms and Subarachnoid Hemorrhage. A Cooperative Study. Philadelphia: JB Lippincott1969 p 71Sahs AL Perret GE Locksley HB et al: Intracranial Aneurysms and Subarachnoid Hemorrhage. A Cooperative Study. Philadelphia: JB Lippincott 1969 p 71

    • Search Google Scholar
    • Export Citation
  • 17.

    Symon L: Vasospasm in aneurysm in Moossy JJaneway R (eds): Cerebrovascular Diseases Seventh Conference. New York: Grune and Stratton1971 pp 232240Symon L: Vasospasm in aneurysm in Moossy J Janeway R (eds): Cerebrovascular Diseases Seventh Conference. New York: Grune and Stratton 1971 pp 232–240

    • Search Google Scholar
    • Export Citation
  • 18.

    Van Der Were AJM: Clinical aspects of subarachnoid hemorrhage and significance of vasospasm. Psychiatr Neurol Neurochir 75:4114151972Van Der Were AJM: Clinical aspects of subarachnoid hemorrhage and significance of vasospasm. Psychiatr Neurol Neurochir 75:411–415 1972

    • Search Google Scholar
    • Export Citation
  • 19.

    Weir BRothberg CGrace Met al: Relative prognostic significance of vasospasm following subarachnoid hemorrhage. Can J Neurol Sci 2:1091141975Weir B Rothberg C Grace M et al: Relative prognostic significance of vasospasm following subarachnoid hemorrhage. Can J Neurol Sci 2:109–114 1975

    • Search Google Scholar
    • Export Citation
  • 20.

    Wilkins RH: Aneurysm rupture during angiography: does acute vasospasm occur? Surg Neurol 5:2993031976Wilkins RH: Aneurysm rupture during angiography: does acute vasospasm occur? Surg Neurol 5:299–303 1976

    • Search Google Scholar
    • Export Citation

Cited By

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 210 210 12
Full Text Views 205 205 2
PDF Downloads 120 120 1
EPUB Downloads 0 0 0

PubMed

Google Scholar