Cerebral venous circulation changes caused by aneurysmal subarachnoid hemorrhage

Clin Hemorheol Microcirc. 2020;74(2):127-138. doi: 10.3233/CH-190573.

Abstract

Background: The aneurysmal subarachnoid hemorrhage (aSAH) is an acute severe hemorrhagic stroke with high morbidity and mortality with poor prognosis.

Objective: This study aims to analyze the changes of cerebral venous circulation in patients with aneurysmal subarachnoid hemorrhage by digital subtraction angiography (DSA).

Materials and methods: Totally, 57 patients with aSAH, 48 patients with unruptured aneurysms, and 45 patients without aneurysms (control group) were enrolled. The microvascular cerebral circulation time (mCCT), venous cerebral circulation time (vCCT), cerebral arterioles and cortical veins were analyzed by DSA.

Results: There were changes of cerebral microvessels and cortical veins in patients with aSAH. The mCCT (6.15±1.37 s) and vCCT (2.79±0.34 s) of aSAH patients significantly increased compared with control patients (3.74±0.50 s; 2.64±0.32 s) (P < 0.05). However, the mCCT increased more compared with vCCT in aSAH patients (P < 0.001), while the vCCT increased more compared with mCCT in severe aSAH cases (P < 0.01). There was no significant difference in mCCT and vCCT between patients with unruptured aneurysms and controls (P = 0.131; P = 0.621).

Conclusions: The mCCT increases in acute aSAH patients within 72 hours and vCCT increases in severe aSAH cases.

Keywords: Aneurysmal subarachnoid hemorrhage; cerebral vein; digital subtraction angiography; microvascular cerebral circulation time; venous cerebral circulation time.

MeSH terms

  • Adult
  • Aged
  • Cerebral Veins / pathology*
  • Cerebrovascular Circulation / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / mortality