Intraoperative brain oxygenation monitoring and vasospasm in aneurysmal subarachnoid hemorrhage

AbstractBackground: Vasospasm is a frequent complication of subarachnoid hemorrhage (SAH), implicated in poor outcome, and prediction of its occurrence might be important on the therapeutic approach of this condition. Brain oxygenation in aneurysmal SAH was prospectively monitored during surgery in 28 patients, using brain tissue oxygen pressure (PbtO2), studying its association with the occurrence of post-operative vasospasm, detected by transcranial Doppler.Methods: PbtO2 monitoring was performed during surgery of 28 patients with aneurysmal SAH, using a polarographic microcatheter (Licox; GMS, Kiel, Germany), inserted into the cerebral tissue. The aneurysms were localized in the anterior communicating artery (AcoA) complex (eight cases), in the posterior communicating artery (Pcom) origin (seven cases), and in the middle cerebral artery (MCA) bifurcation (13 cases). Basal PbtO2 values, obtained immediately before application of temporary or definitive clips, were studied according to age, clinical stat...