Effect of colloidal solution on cerebral blood flow in patients with cerebral vasospasm after aneurysmal subarachnoid hemorrhage
10.3969/j.issn.1672-5921.2012.07.004
- Author:
Yue-Qiao XU
1
Author Information
1. Department of Neurosurgery
- Publication Type:Journal Article
- Keywords:
Colloidal solution;
Intracranial aneurysm;
Subarachnoid hemorrhage;
Vasospasm, intracranial;
Volume expansion
- From:
Chinese Journal of Cerebrovascular Diseases
2012;9(7):352-356
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effect of colloidal solution infusion on cerebral blood flow in patients with cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Methods: Thirty patients diagnosed as aneurysmal subarachnoid hemorrhage with digital subtraction angiography (DSA) were divided into a vasospasm group (n = 12) and a control group (n = 18) according to whether they had cerebral vasospasm or not. After evaluating the regional cerebral blood flow (rCBF) of the bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery with Xe-CT, the colloidal solution (succinylated gelatin, 4 mL/kg) was injected intravenously in the patients of the vasospasm group within 30 minutes. Xe-CT was performed again, and the changes of rCBF before and after the colloidal solution expansion were compared. The changes of blood pressure, heart rate, and central venous pressure before and after infusion were documented. Results: Circled digit oneThe rCBF of bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery was more than 30 mL·100 g-1·min -1 in the control group. The rCBF was lower than 30 mL·100 g-1·min-1at least in 1 blood supplied region in the vasospasm group (72 blood supply regions altogether) , in which CBF were lower than 25 mL·100 g-1·min-1 in 7 blood supplied regions. Circled digit twoBefore and after the expansion, there were no significant differences among the systolic and diastolic blood pressure, mean arterial pressure, and central venous pressure in the vasospasm group (P >0.05). Circled digit threeOf the 65 vessels with rCBF >25 mL·100 g-1·min-1 there were no significant differences in rCBF before and after the expansion (P = 0.272) ; of the 7 vessels with rCBF ≤ 25 mL·100 g-1·min-1, the rCBF increased from 20 ± 3 mL·100 g-1·min-1to 34 ± 6 mL·100 g-1·min-1. There were significant differences (P <0.01). Circled digit oneOne year follow-up after the procedure, there was no significant difference in GOS score between the 2 groups. Conclusion: Colloidal solution expansion may increase the rCBF of the ischemic regions in patients with cerebral vasospasm and help to improve the prognosis of the patients.
