1 Neurokirurgisk Klinik, Neurocentret, Rigshospitalet, The Capital Region of Denmark2 Neuroanæstesiologisk Klinik, Neurocentret, Rigshospitalet, The Capital Region of Denmark3 Radiologisk Klinik, Diagnostisk Center, Rigshospitalet, The Capital Region of Denmark
The use of endovascular intervention to treat cerebral vasospasm after subarachnoid hemorrhage has increased. Although the effect on angiographic vasospasm can be easily demonstrated, the effect on cerebral blood flow and clinical outcome is still controversial. In this report, we investigate minute-by-minute changes in brain tissue oxygen during balloon angioplasty and intraarterial administration of vasodilators in three patients.Our results confirm that endovascular intervention is capable of not only resolving angiographic vasospasm, but also of normalizing values of brain tissue oxygen pressure (PtiO₂) in target parenchyma. However, during the intervention, dangerously low levels of brain tissue oxygen, leading to cerebral infarction, may occur. Thus, no clinical improvement was seen in two of the patients and a dramatic worsening was observed in the third patient. Because the decrease in brain tissue oxygen was seen after administration of vasopressor agents, this may be a contributing factor.
Acta Neurochirurgica. Supplementum, 2015, Vol 120, p. 183-6