Cerebral blood flow dynamics and head-of-bed changes in the setting of subarachnoid hemorrhage

David K Kung; Nohra Chalouhi; Pascal M Jabbour; Robert M Starke; Aaron S Dumont; H Richard Winn; Matthew A Howard III; David M Hasan

doi:10.1155/2013/640638

Back

Cerebral blood flow dynamics and head-of-bed changes in the setting of subarachnoid hemorrhage

Journal article

Open access

Peer reviewed

Cerebral blood flow dynamics and head-of-bed changes in the setting of subarachnoid hemorrhage

David K Kung, Nohra Chalouhi, Pascal M Jabbour, Robert M Starke, Aaron S Dumont, H Richard Winn, Matthew A Howard III and David M Hasan

BioMed research international, Vol.2013, 640638

2013

DOI: 10.1155/2013/640638

PMCID: PMC3859207

PMID: 24371827

Files and links (1)

url

https://doi.org/10.1155/2013/640638View

Published (Version of record) Open Access

Abstract

Head-of-bed (HOB) elevation is usually restricted in patients with aneurysmal subarachnoid hemorrhage (SAH). The goal of this study is to correlate HOB changes (0° and 90°) with cerebral blood flow using transcranial Doppler (TCD) and thermal diffusion probe in SAH patients. Thirteen patients with SAH were prospectively enrolled in the study. Eight patients underwent placement of a thermal diffusion probe for regional CBF measurement. CBF values were measured with the patients in flat (0°) and upright sitting positions (90°) at days 3, 7, and 10. The average increase in blood flow velocity when changing HOB from 0° to 90° was 7.8% on day 3, 0.1% on day 7, and 13.1% on day 10. The middle cerebral artery had the least changes in velocity. The average regional CBF measurement was 22.7 ± 0.3 mL/100 g/min in the supine position and 23.6 ± 9.1 mg/100 g/min in the sitting position. The changes were not statistically significant. None of the patients developed clinical cerebral vasospasm. Changing HOB position in the setting of SAH did not significantly affect cerebral or regional blood flow. These data suggest that early mobilization should be considered given the detrimental effects of prolonged bed rest.

Brain - diagnostic imaging

Subarachnoid Hemorrhage - therapy

Humans

Middle Aged

Male

Tomography, X-Ray Computed

Cerebrovascular Circulation

Subarachnoid Hemorrhage - diagnostic imaging

Subarachnoid Hemorrhage - pathology

Brain - blood supply

Blood Flow Velocity

Middle Cerebral Artery - physiopathology

Aged, 80 and over

Brain - pathology

Adult

Female

Aged

Details

Title: Subtitle: Cerebral blood flow dynamics and head-of-bed changes in the setting of subarachnoid hemorrhage
Creators: David K Kung - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, JCP 1616, Iowa City, IA 52242, USA
Nohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA, USA
Pascal M Jabbour - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA, USA
Robert M Starke - Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA
Aaron S Dumont - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA, USA
H Richard Winn - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, JCP 1616, Iowa City, IA 52242, USA
Matthew A Howard III - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, JCP 1616, Iowa City, IA 52242, USA
David M Hasan - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, JCP 1616, Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: BioMed research international, Vol.2013, 640638
DOI: 10.1155/2013/640638
PMID: 24371827
PMCID: PMC3859207
NLM abbreviation: Biomed Res Int
ISSN: 2314-6133
eISSN: 2314-6141
Publisher: United States
Language: English
Date published: 2013
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984016817102771

Metrics

27 Record Views

13 Times Cited - Web of Science