RIU 436 Lecture Notes - Lecture 45: Intracranial Aneurysm, Subarachnoid Hemorrhage, Cerebral Circulation

• School: GVSU
• Department: Radiation and Imaging - Ultrasound
• Course: RIU 436
• Professor: Miram Teft

Document Summary

The transient and delayed narrowing of basal cerebral arteries following subarachnoid hemorrhage (sah)- when an intracranial aneurysm ruptures and a large amount of blood pooling into the head. Vessel wall to spasm and clamp down shutting down distal flow to cerebral tissues and can result in stroke- devastating. Vasospasm usually begins within 3 to 4 days after sah, peaks around 6 to 8 days, and resolves within 2 to 4 weeks. Management relies on hemodynamic therapy to improve cerebral blood flow. Tcd used to detect elevated blood velocities indicative of vasospasm and to identify patients at risk of delayed ischemic neurologic deficits (dinds) Patients are monitored daily for the following vasospasm events. With hemodynamically significant extracranial carotid artery stenosis, the brain will compensate with collateral flow and autoregulation. Tcd can help identify and assess presence and adequacy of collateral circulation. Tcd can also help predict hemodynamic consequences of cross-clamping during carotid endarterectomy. Eca to ica through reversed ophthalmic artery.