Prediction of Symptomatic Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage Using Early Transcranial Doppler

Claudio E Scherle Matamoros; Edgar A Samaniego; Kimberly Sam; Jorge A Roa; Jesús Pérez Nellar; Danny Rivero Rodríguez

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Prediction of Symptomatic Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage Using Early Transcranial Doppler

Journal article

Open access

Peer reviewed

Prediction of Symptomatic Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage Using Early Transcranial Doppler

Claudio E Scherle Matamoros, Edgar A Samaniego, Kimberly Sam, Jorge A Roa, Jesús Pérez Nellar and Danny Rivero Rodríguez

Journal of vascular and interventional neurology, Vol.11(1), pp.19-26

01/2020

PMCID: PMC6998809

PMID: 32071668

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998809/View

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Abstract

Symptomatic vasospasm (sVSP) is a common complication during the course of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to evaluate the efficacy and accuracy of transcranial Doppler ultrasound (TCD), performed within the first 3 days of aSAH to predict the development of sVSP. We performed a retrospective analysis of our institutional prospectively collected database of patients with aSAH. Patients with aSAH and World Federation of Neurosurgical Societies (WFNS) grades I-III were included in the analysis. A receiver operating characteristic (ROC) curve was generated to determine cut-off values for mean flow velocities (MFVs) in the middle cerebral artery (MCA) and anterior cerebral artery (ACA) bilaterally to predict sVSP. Fifty-one patients were included in the study. Mean age was 49.8 ± 10.2 years, and 84.3% (43 patients) were women. The accuracy of measured MFVs to predict sVSP was 0.79 [95% confidence interval (CI), 0.69-0.89] and 0.77 (95% CI, 0.64-0.91) for the MCA and the ACA, respectively. In the MCA, an MFV ≥ 74 cm/s was significantly associated with a six-fold increased risk of sVSP, achieving sensitivity greater than 70%. In the ACA, an MFV ≥ 64 cm/s was significantly associated with a nine-fold increased risk of sVSP. Early TCD evaluation of MFVs in the MCA and ACA is a useful tool to predict the development of sVSP in patients with acute aSAH.

transcranial Doppler

intracranial aneurysm

cerebral vasospasm

subarachnoid hemorrhage

ultrasound

Details

Title: Subtitle: Prediction of Symptomatic Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage Using Early Transcranial Doppler
Creators: Claudio E Scherle Matamoros - Department of Neurology, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador
Edgar A Samaniego - Department of Neurology, Neurosurgery and Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Kimberly Sam - Department of Neurology, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador
Jorge A Roa - Department of Neurology and Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Jesús Pérez Nellar - Department of Neurology, Hospital Clínico-Quirúrgico Hermanos Ameijeiras, Havana, Cuba
Danny Rivero Rodríguez - Department of Neurology, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador
Resource Type: Journal article
Publication Details: Journal of vascular and interventional neurology, Vol.11(1), pp.19-26
Publisher: United States
PMID: 32071668
PMCID: PMC6998809
ISSN: 1941-5893
eISSN: 1944-141X
Language: English
Date published: 01/2020
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984072062002771

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