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May 1968

On the Significance of Spasm Associated With Rupture of a Cerebral Aneurysm: The Relationship Between Spasm as Noted Angiographically and Regional Blood Flow Determinations

Author Affiliations

New York
From the Neuroradiology Section of the Radiology Department (Drs. Zingesser and Schechter), and the Saul Korey Neurology Department (Drs. Dexter, Katzman, and Scheinberg), Albert Einstein College of Medicine, Bronx, NY.

Arch Neurol. 1968;18(5):520-528. doi:10.1001/archneur.1968.00470350078007

THE SIGNIFICANCE of spasm associated with rupture of a cerebral aneurysm has interested many workers. The etiology of the spasm remains obscure. The significance of the spasm in the etiology of infarction is debated. Stornelli and French1 and Allcock and Drake2 indicate that spasm has great prognostic significance. Crompton3,4 and Schneck5,6 indicate the importance of factors other than spasm in the pathogenesis of infarction.

The angiographic evaluation of spasm is based on analysis of arterial phases of the angiographic study with the spasm being categorized as local or diffuse spasm. A further descriptive classification based on the severity of the spasm divided cases into three groups: grade 1 spasm, where the caliber of the vessel involved is narrowed by less than 50%; grade 2 spasm, where the vessel is narrowed by more than 50%; and grade 3 spasm, where the vessel is barely visible. Since

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