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The catheter is placed in areas at risk for hypoperfusion and can further help detect intracerebral vasospasm and assess cerebrovas- cular autoregulation.57 However, there are still concerns about the validity of using thermal diffusion flowmetry long-term, as monitor dysfunctions secondary to placement errors and missing data during recalibration occur.58
, arterial vaso- spasm) or vascular stenosis.60 High flow velocities in the middle cerebral artery (MCA) can be caused by vasospasm or hyperemia.
84.6 and 84.7).103 After SAH, the Hijdra sum score seems to be superior to the more commonly used modified Fisher scale in assessing the amount of subarachnoid blood and in predicting the occurrence and severity of cere- bral vasospasm.104,105 (Tables 84.8 and 84.9).
Although the exact mechanism of DCI is still unclear, multiple potential causes beyond cerebral vasospasm have been investigated, including microcirculatory dysfunction, microthrombosis, cortical spreading depolarization, and neuroinflammation.175,176 About one-third of patients will develop symptoms from DCI as early as 3 to 5 days after the
Seventy percent of patients will develop angiographic vasospasm, although only 30% to 40% of patients will become symptomatic.
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