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首页> 美国卫生研究院文献>Journal of Cerebral Blood Flow Metabolism >Placing intracerebral probes to optimise detection of delayed cerebral ischemia and allow for the prediction of patient outcome in aneurysmal subarachnoid haemorrhage
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Placing intracerebral probes to optimise detection of delayed cerebral ischemia and allow for the prediction of patient outcome in aneurysmal subarachnoid haemorrhage

机译：放置脑内探头以优化延迟性脑缺血的检测并预测动脉瘤性蛛网膜下腔出血的患者预后

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Cerebral microdialysis could be useful to detect delayed cerebral ischemia in aneurysmal subarachnoid haemorrhage patients. The optimal location of the probes, however, remains controversial. Here, we determined the vascular territories with the highest infarct risk in relation to aneurysm location to define probe implantation guidelines. These guidelines were retrospectively validated by studying the likelihood of probe to fall in a secondary infarct area, and by analysing their influence to predict patient outcome. The vascular territories with highest risk of infarction were the anterior cerebral arteries for anterior communicating artery aneurysms and the ipsilateral middle cerebral artery for internal carotid artery, posterior communicating artery and middle cerebral artery aneurysms. When cerebral microdialysis probes had been implanted in these territories, 79% were located within an infarcted area versus 54% when they were implanted in other territories. Delayed cerebral ischemia was detected only when the probe was located within a brain area later affected by secondary infarction, which could justify the use of implantation guidelines. Moreover, individual patient outcomes could be predicted when probes were placed in the brain territories as suggested by this study. Thus, a precise probe placement algorithm can improve delayed cerebral ischemia detection sensitivity and allow for a better prediction concerning patient outcome.
机译：脑微透析可用于检测动脉瘤性蛛网膜下腔出血患者的延迟性脑缺血。然而，探针的最佳位置仍存在争议。在这里，我们确定了与动脉瘤位置相关的梗塞风险最高的血管区域，以定义探针植入指南。通过研究探头落入继发性梗塞区域的可能性并分析其对患者预后的影响，对指南进行了回顾性验证。发生梗塞风险最高的血管区域是前交通动脉瘤的前脑动脉，颈内动脉，后交通动脉和脑中动脉瘤的同侧大脑中动脉。将脑微透析探针植入这些地区时，有79％位于梗塞区域，而植入其他地区时为54％。仅当探针位于后来受继发性梗塞影响的大脑区域内时，才检测到延迟性脑缺血，这可以证明使用植入指南是合理的。此外，如本研究所建议的，当将探头放置在脑部区域时，可以预测单个患者的结果。因此，精确的探针放置算法可以提高延迟性脑缺血检测的敏感性，并可以更好地预测患者的预后。

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