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Clinical vasospasm, or delayed ischemia-related neurologic deficits, is the prime
determinant of morbidity and mortality after subarachnoid hemorrhage. The diagnosis
of clinical vasospasm has been based mainly on clinical observations. Noninvasive
techniques for evaluating vasospasm have great promise in supplementing the detailed
neurologic examination and assessing the effects of therapy. The clinical utility
of single-photon emission computed tomography (SPECT) of regional cerebral blood flow
and transcranial Doppler ultrasound (TCD) in the evaluation of cerebral vasospasm
after subarachnoid hemorrhage was reviewed in 40 patients. The combination of these
noninvasive tests was valuable for the investigation of the dynamic anatomic and functional
aspects of vasospasm. TCD proved helpful in monitoring for vascular narrowing by measurements
of blood flow velocity. Brain SPECT ascertained the effects of vasospasm on regional
cerebral blood flow. In the diagnosis of clinical vasospasm, or delayed ischemic deficits,
brain SPECT was more sensitive and specific than TCD. The combination of SPECT and
TCD was useful in the assessment of the effect of cerebral angioplasty on hemodynamics
and perfusion in the attempt to avert infarction.
Keywords
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© 1992 National Stroke Association. Published by Elsevier Inc. All rights reserved.
