Monitorage de la saturation veineuse jugulaire en oxygène au cours d'un vasospasme cérébral sévère après hémorragie sous-arachnoïdienne

Abstract

Jugular venous oximetry in a patient with severe cerebral vasospasm after subarachnoid haemorrhage. Cerebral arterial vasospasm is a major complication of aneurysmal subarachnoid haemorrhage. The conventional treatment of this complication includes haemodilution, hypervolaemia, arterial hypertension and nimodipine. Some patients do not respond to this therapy and require an intra-arterial infusion of papaverine and/or a cerebral angioplasty. Transcranial Doppler detects cerebral vasospasm. However it does not provide an accurate metabolic information on the ischaemic status of the cerebral tissue. This article describes the monitoring of jugular venous bulb oxygen saturation to obtain a real time information on the metabolic effect of cerebral vasospasm and its variations after intra-arterial infusion of papaverine.