Is transcranial Doppler sonography useful in detecting late cerebral ischaemia after aneurysmal subarachnoid haemorrhage?

Br J Neurosurg. 1996 Feb;10(1):19-25. doi: 10.1080/bjn.10.1.19.

Abstract

Transcranial Doppler (TCD) examination was performed in 109 patients with aneurysmal subarachnoid haemorrhage. Fifty-seven demonstrated flow velocities exceeding 120 cm/s in the middle cerebral artery. Of these, 23 developed delayed ischaemic deficit (DID). Mean flow velocity in this group was 170, SD 12.8 cm/s, in comparison with 155, SD 11.2 cm/s in the 34 patients without late signs of cerebral ischaemia. This difference is significant (p = 0.0269). In the 34 patients without DID, but TCD > 120 cm/s, 17 received anti-ischaemic therapy based on TCD values only, while 17 were given no additional treatment. The mean TCD values and the neurological outcome in the two groups were similar. A rapid increase in flow velocities of 50 cm/s or more during a 24-h period seemed to be a strong predictor of symptomatic vasospasm as seven out of 12 patients developed DID, five with permanent neurological sequelae. The study confirms results from other centres, that a strict correlation between high TCD flow velocities and occurrence of DID does not exist.

MeSH terms

  • Adult
  • Aged
  • Calcium Channel Blockers / administration & dosage
  • Calcium Channel Blockers / therapeutic use*
  • Cerebral Arteries / physiopathology
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / physiopathology
  • Ischemic Attack, Transient / diagnostic imaging*
  • Ischemic Attack, Transient / drug therapy
  • Ischemic Attack, Transient / etiology
  • Middle Aged
  • Nimodipine / administration & dosage
  • Nimodipine / therapeutic use
  • Severity of Illness Index
  • Subarachnoid Hemorrhage / complications*
  • Ultrasonography, Doppler, Transcranial*

Substances

  • Calcium Channel Blockers
  • Nimodipine