Cerebrovascular reactivity after treatment of unruptured intracranial aneurysms — A transcranial Doppler sonography and acetazolamide study

Bøthun, Marianne Lundervik; Haaland, Øystein Ariansen; Logallo, Nicola; Svendsen, Frode; Thomassen, Lars; Helland, Christian A.

doi:10.1016/j.jns.2015.12.024

Cited by 6 publications

(16 citation statements)

References 51 publications

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“…In a previous study, we analyzed early postoperative CVR data from patients treated for UIA in the Department of Neurosurgery, Haukeland University Hospital, between February 2011 and May 2013 [ 18 ]. The patients were treated with either endovascular coiling or surgical clipping, and they were examined within the first week after aneurysm treatment.…”

Section: Methodsmentioning

confidence: 99%

“…CVR testing was performed using transcranial Doppler (TCD) monitoring of blood flow velocities in the middle cerebral arteries (MCA) before, during, and after intravenous injection of acetazolamide (AZ). The method has previously been described in detail [ 18 ]. Except for an additional manufacturer of AZ, the method of CVR testing was identical to the initial study [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…The method has previously been described in detail [ 18 ]. Except for an additional manufacturer of AZ, the method of CVR testing was identical to the initial study [ 18 ]. The AZ manufacturers used in this study were Goldshield Ltd., Croydon, Surrey, UK; Sanofi Aventis, Paris, France; and Mercury Pharmaceuticals Ltd., Croydon, Surrey, UK.…”

Section: Methodsmentioning

confidence: 99%

“…To simplify analyses, patients with midline aneurysms were allocated to the side chosen for endovascular or surgical approach. As in the previous study [ 18 ], mean CVR of the two sides (right and left) was calculated for all individuals. If the measurement on one side was missing, the mean CVR was set to the nonmissing value.…”

Section: Methodsmentioning

confidence: 99%

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Time Course of Cerebrovascular Reactivity in Patients Treated for Unruptured Intracranial Aneurysms: A One-Year Transcranial Doppler and Acetazolamide Follow-Up Study

Bøthun

Haaland

Logallo

et al. 2018

BioMed Research International

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Background Cerebrovascular reactivity (CVR) is often impaired in the early phase after aneurysmal subarachnoid hemorrhage. There is, however, little knowledge about the time course of CVR in patients treated for unruptured intracranial aneurysms (UIA). Methods CVR, assessed by transcranial Doppler and acetazolamide test, was examined within the first postoperative week after treatment for UIA and reexamined one year later. Results Of 37 patients initially assessed, 34 were reexamined after one year. Bilaterally, baseline and acetazolamide-induced blood flow velocities were higher in the postoperative week compared with one year later (p < 0.001). CVR on the ipsilateral side of treatment was lower in the initial examination compared with follow-up (58.9% versus 66.1%, p = 0.04). There was no difference in CVR over time on the contralateral side (63.4% versus 65.0%, p = 0.65). When mean values of right and left sides were considered there was no difference in CVR between exams. Larger aneurysm size was associated with increased change in CVR (p = 0.04), and treatment with clipping was associated with 13.8%-point increased change in CVR compared with coiling (p = 0.03). Conclusion Patients with UIA may have a temporary reduction in CVR on the ipsilateral side after aneurysm treatment. The change in CVR appears more pronounced for larger-sized aneurysms and in patients treated with clipping. We recommend that ipsilateral and contralateral CVR should be assessed separately, as mean values can conceal side-differences.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Time Course of Cerebrovascular Reactivity in Patients Treated for Unruptured Intracranial Aneurysms: A One-Year Transcranial Doppler and Acetazolamide Follow-Up Study

Bøthun

Haaland

Logallo

et al. 2018

BioMed Research International

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“…21 In this study the rate of mortality in using acetazolamid in increasing blood flow and better performance of brain was confirmed and our study results in line with Bothun and et al study. 22…”

Section: Discussionmentioning

confidence: 99%

The effect of acetazolamide on intracerebral hemorrhage in stoke patients

2017

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Background: 10-20% of all strokes are caused by intracerebral haemorrhage which is the world's leading cause of neural tube defects and the second cause of mortality in the world. The aim of this study was to assessment the effect of acetazolamide in the symptom improvement, decreasing rankin scale and mortality rate in patients with intracerebral haemorrhage.Methods: This is a clinical trial study that has been done on 120 stroke patients which divided randomly in two groups each with 60 patients. Patients in intervention group take acetazolamide 750 mg/day and in control group take placebo. The status of patients investigated by Rankin scale in three times baseline, 72 hours and 3 weeks after Cerebral haemorrhage.Results: Of all patients, 49 (40.8%) were male and 71 (59.1%) were female. Putamen haemorrhage is the most location for cerebral haemorrhage (n = 43, 35.8%). According to the Rankin scale, 53 (44.2%) of patients were in the status 4 “moderately severe disability. Unable to attend to own bodily needs without assistance and unable to walk unassisted” in baseline. In the intervention group based on Rankin scale after 72 hour and three week the recovery rate was significantly more than control group.Conclusions: Acetazolamide can be effective in treatment haemorrhagic stroke, decreasing Rankin scale and mortality rate in patients with cerebral haemorrhage.

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Aneurysmal Subarachnoid Hemorrhage and Endovascular Treatment: Usefulness of Transcranial Doppler (TCD/TCCS) for Cerebral Hemodynamic Monitoring

Estrany

2021

Neurosonology in Critical Care

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Subarachnoid hemorrhage (SAH) is a devastating disease with high morbidity and mortality. Delayed cerebral ischemia due to vasospasm is one of the main hemodynamic complications. Up to 30% of patients may develop delayed cerebral ischemia related to vasospasm. Early detection can guide clinical decisions at patient's bedside. 2. Transcranial Doppler (TCD/TCCS) is an accessible and reproducible tool, applicable for the monitoring of cerebral blood flow velocities (CBFVs) and hemodynamic indexes derived from them. 3. The use of Echo-contrast may increase the sensitivity of the detection of unruptured intracranial aneurysms and their recanalization after endovascular treatment. 4. New technologies of TCD can improve its sensitivity. It allows intraoperative and continuous monitoring in patients at high risk of developing vasospasm.

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Cerebrovascular reactivity after treatment of unruptured intracranial aneurysms — A transcranial Doppler sonography and acetazolamide study

Cited by 6 publications

References 51 publications

Time Course of Cerebrovascular Reactivity in Patients Treated for Unruptured Intracranial Aneurysms: A One-Year Transcranial Doppler and Acetazolamide Follow-Up Study

Time Course of Cerebrovascular Reactivity in Patients Treated for Unruptured Intracranial Aneurysms: A One-Year Transcranial Doppler and Acetazolamide Follow-Up Study

The effect of acetazolamide on intracerebral hemorrhage in stoke patients

Aneurysmal Subarachnoid Hemorrhage and Endovascular Treatment: Usefulness of Transcranial Doppler (TCD/TCCS) for Cerebral Hemodynamic Monitoring

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