gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

Article

Send article

The influence of blood glucose level on cerebral perfusion after aneurysmal subarachnoid hemorrhage

Meeting Abstract

Search Medline for

  • Kerim Beseoglu - Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Ursala Tokhi - Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Daniel Hänggi - Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Klinik für Neurochirurgie, Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.08.01

doi: 10.3205/15dgnc290, urn:nbn:de:0183-15dgnc2909

Published: June 2, 2015

© 2015 Beseoglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Delayed cerebral ischemia (DCI) is a severe complication and significant contributor to poor neurological outcome following aneurysmal subarachnoid hemorrhage (aSAH). However, underlying causes and risk factors are still incompletely understood and subject of current research. An influence of blood glucose dysregulation on the occurrence of DCI is assumed. This study aims to analyze the influence of systemic blood glucose level on cerebral perfusion measured by dynamic perfusion computed tomography (PCT) in patients with aSAH.

Method: Daily serial blood glucose levels and PCT data sets of 220 patients treated at our neurointensive care unit after aSAH were retrospectively analyzed. PCT was performed at 24 hours after aneurysm occlusion, at day 2 to 4 after SAH and between day 9 to 11. We focused on the mean transit time (MTT) and cerebral blood flow (CBF) as the most relevant perfusion parameters in the presence of impaired cerebral perfusion from DCI. The maximum MTT (maxMTT) and minimum CBF (minCBF) parameters were correlated with defined blood glucose ranges according to recent publications as followed: 1.) >180mg/dl (Hyperglycemia) 2.) 140-180mg/dl (elevated glucose level) 3.) 110-140mg/dl (strict glucose control) and <110mg/dl (low glucose level).

Results: Elevated blood glucose levels (140-180mg/dl) showed a negative correlation with the minCBF (p=0.01 r=-0.173) whereas low blood glucose (<110mg/dl) correlated significantly positive with minCBF (p<0.01 r=0.178). Hyperglycemia (>180mg) and elevated glucose levels (140-180mg/dl) were associated with prolonged maxMTT (median 4.13s and 4.24s ) in contrast to low glucose levels (<110mg/dl) (median 3.75s p=0.019, p<0.01). In addition, a strict control of blood glucose (110-140mg/dl) was shown to correlate significantly with lower maxMTT (p< 0.01 r=-0.180).

Conclusions: The present analysis supports the assumption that dysregulation of blood glucose balance influences cerebral perfusion and thus may contribute to the occurrence of DCI. Therefore careful monitoring and prompt treatment of blood glucose levels after aSAH should be highly valued and prospective research is warranted to further define optimum values for blood glucose levels.