[A regional cerebral blood flow in patients with acute subarachnoid hemorrhage--with special references to spasm (author's transl)].

Measurements of the regional cerebral blood flow (rCBF) were performed 44 times on patients with subarachnoid hemorrhage, using the 133-Xe clearance method with aid of the 8 channel detector unit. The patients consisted of 31 preoperative cases within 3 weeks of the last subarachnoid hemorrhage. The sites of the ruptured aneurysms included 11 anterior communicating arteries, 8 middle cerebral arteries, 7 internal carotid arteries and 3 anterior cerebral arteries. In 2 cases, the aneurysms were not identified with the cerebral angiograms. The purpose of this study was to investigate the effect of spasm on the rCBF. The subjects were divided into two groups: those with and without spasm. Furthermore, the group with spasm was divided into three subgroups according to the degree of spasm. The findings obtained were as follows; The group with spasm showed a statistically significant decrease in the mean of the rCBF. The MrCBF was not influenced by the distribution of spasm, however. In the group without spasm, the MrCBF had a good correlation with the cerebrospinal fluid pressure (CSF-P) or the level of consciousness. In the group with spasm, there was no correlation between the MrCBF and the CSF-P or the level of consciousness. For example that marked reduction of the MrCBF were seen in some cases with low CSF-P or only slight disturbance of consciousness. The rCBF was measured 2 or 3 times in 5 cases with spasm. The decrease in MrCBF occured about one week after the incidence of the subarachnoid hemorrhage but MrCBF recovered with the disappearance of spasm 2 or 3 weeks after the attack. There was a poor correlation between spasm and relative flow patterns. The good correlation, however, was found in only one case with the severe spasm at the middle cerebral artery.