• Leodante da Costa, David Houlden, Gordon Rubenfeld, Michael Tymianski, Joseph Fisher, and Jorn Fierstra.
• Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room A1-37, Toronto, ON, M4N 3M5, Canada, leo.dacosta@sunnybrook.ca.
• Acta Neurochir. Suppl. 2015 Jan 1; 120: 249-53.

ObjectiveSubarachnoid hemorrhage (SAH) alters cerebrovascular reactivity (CVR) to carbon dioxide (CO2), which may be related to an increased risk of delayed ischemic neurological deficits (DINDs). We report the results of bedside CVR testing in the acute phase of SAH in good clinical grade patients without established vasospasm or signs of DIND.Materials And MethodsEighteen patients with SAH and 26 healthy subjects underwent CVR testing using transcranial Doppler with standardized changes in CO₂. None of the patients had clinical or radiological evidence of vasospasm or DIND at time of testing. A CVR index was calculated as the change in the middle cerebral artery blood flow velocity (MCAv) divided by the change in the end-tidal CO₂partial pressure (PCO₂), ∆ MCAv/Δ PCO₂, and values were compared with controls.ResultsSAH patients had lower CVR when compared with normal controls (p = 0.0001 and p = 0.0094, respectively). Impaired CVR was not correlated with future vasospasm (p = 0.2).ConclusionsPatients with SAH had significantly lower CVR indexes compared with healthy controls. Although impaired CVR was present in 50 % of the patients early after SAH, no correlation with later occurrence of DINDs was found.

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