Regional cerebral blood flow in patients with ruptured intracranial aneurysms

Abstract

Studies (85) of regional cerebral blood flow (rCBF) were performed on 49 patients with ruptured intracranial aneurysms. Changes in rCBF were analyzed under various pathophysiological conditions. The degree of flow abnormality correlated well with the clinical severity of neurological deficits. All patients with diffuse vasospasm of severe grade, to < 1/2 their control value, showed focal areas of decreased flow below 30 ml/100 g per min and a reduction in mean CBF. The relief or disappearance of vasospasm in angiograms was followed by increased rCBF at the ischemic focus and mean CBF. Marked reduction in rCBF was found in patients with intracerebral hematoma and ventricular dilatation. Impaired CO2 response and autoregulation were found in patients with severe neurological deficits, a severe degree of vasospasm and marked depression of mean CBF. Direct operation was delayed in patients with impaired vascular reactivity and marked decrease of mean CBF < 30 ml/100 g per min; good clinical results were obtained in these patients.