Transcranial Doppler in diagnosis of cerebral vasospasm-A comparative study

Objective The purpose of this study is to evaluate intracranial blood flow conditions in patients with subarachnoid hemorrhage with transcranial Doppler(TCD),and to investigate the reliability of TCD in diagnosis of cerebral vasospasm(CVS)by comparing with the subtraction digital angiography(SDC)result.Methods49 patients who underwent TCD examination between 2000 and 2005 were involved in this study.All the patients had appearance of subarachnoid hemorrhage for grade Ⅰ~Ⅲ on computerized tomography(CT)scan(grade Ⅳ~Ⅴ were excluded because too serious to endure angiography).From the first day of making a definite diagnosis,TCD were performed every three days,and the observation lasted for ten days.Evaluated parameters included:The Peak and mean velocity(Vs and Vm)of Middle cerebral artery(MCA),Distal internal carotid artery(TICA)and Extracranial internal carotid artery(EICA).Ratio of MCA and EICA(VMCA/VICA)was calculated,and SDC for each person were also performed.ResultsAmong the 49patients,TCD suggested 26 were CVS,and 33 vasospasm vessels in total.SDC results showed there were 31CVS patients,and 36 vasospasm vessels in total.Specification of TCD in CVS diagnosis was 83.8%,and the specification was 91.6%.ConclusionCompared with the SDC,TCD has its advantages for flexible operations,low cost,real-time and non-invasive,sensitive and effective,and good reproducibility.