AMOUNT OF SUBARACHNOID BLOOD AND VASOSPASM - CURRENT ASPECTS A TRANSCRANIAL DOPPLER STUDY

Subsequent to admission after aneurysmal subarachnoid haemorrhage (SAH ), 120 patients (74 women and 46 men) underwent microsurgical clipping of a total of 158 cerebral aneurysms within 96 hours after the bleed. Their mean age was 46 (20-91) years. Computed tomography (CT) finding s were graded according to the modified Fisher scale and ail patients had daily transcranial doppler (TCD) recordings of their basal cerebra l arteries. In 19% of SAH was grade I on CT, in 44% grade II and in 37 % grade III. The rate of patients who developed severe vasospasm as do cumented by TCD (mean blood flow velocities exceeding 160 cm/s on 2 or more consecutive days) was 39% for grade I patients, 26% for grade II patients and 34% for patients with SAH grade III on the initial CT. T here was no difference in the rate of occurrence of severe vasospasm, when the patients were split into 2 groups according to the time of pe rformance of the initial CT scan-within 24 hours, and 48-80 hours afte r SAH, respectively. It is concluded that the amount of subarachnoid b lood on the initial CT scan should no longer be used as the indicator for occurrence and severity of the multifactorial entity vasospasm.