Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage

M A Sloan; E C Haley Jr; N F Kassell; M L Henry; S R Stewart; R R Beskin; E A Sevilla; J C Torner

doi:10.1212/wnl.39.11.1514

Back

Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage

Journal article

Peer reviewed

Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage

M A Sloan, E C Haley Jr, N F Kassell, M L Henry, S R Stewart, R R Beskin, E A Sevilla and J C Torner

Neurology, Vol.39(11), pp.1514-1514

11/1989

DOI: 10.1212/wnl.39.11.1514

PMID: 2682350

View Online

Abstract

Vasospasm is the leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage (SAH). Transcranial Doppler ultrasonography (TCD) can detect the arterial narrowing noninvasively, but the sensitivity and specificity of this technique have not been reported in a population of patients with a high frequency of angiographic vasospasm. In this study, 34 consecutive patients with SAH undergoing angiography during the period of risk for vasospasm had technically adequate TCD examinations within 24 hours of the angiogram. Using a mean flow velocity of 120 cm/sec and above as indicative of vasospasm, TCD correctly detected angiographic vasospasm in 17 patients; there were no false positives. It correctly determined that 5 patients did not have vasospasm, whereas there were 12 false negatives. False negatives were frequently due to angiographic vasospasm involving vessels not assessable by TCD. The correlation between mean flow velocity and the angiographic residual lumen diameter of the middle cerebral artery was statistically significant. These data suggest that TCD is a highly specific (100%), but less sensitive (58.6%) test for the detection of angiographic vasospasm following SAH. Confirmatory angiography may be avoided if the TCD study is positive, but additional studies may be necessary if the clinical picture is suspicious and the TCD study is negative.

Predictive Value of Tests

Humans

False Negative Reactions

Ischemic Attack, Transient - diagnostic imaging

Cerebrovascular Circulation

Subarachnoid Hemorrhage - complications

Ischemic Attack, Transient - diagnosis

Cerebral Angiography

Ischemic Attack, Transient - etiology

Sensitivity and Specificity

Cerebral Arteries - pathology

Skull

Ultrasonography - methods

Details

Title: Subtitle: Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage
Creators: M A Sloan - Department of Neurology, University of Virginia School of Medicine, Charlottesville 22908
E C Haley Jr
N F Kassell
M L Henry
S R Stewart - University of Virginia
R R Beskin
E A Sevilla
J C Torner
Resource Type: Journal article
Publication Details: Neurology, Vol.39(11), pp.1514-1514
DOI: 10.1212/wnl.39.11.1514
PMID: 2682350
NLM abbreviation: Neurology
ISSN: 0028-3878
eISSN: 1526-632X
Publisher: United States
Language: English
Date published: 11/1989
Academic Unit: Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983996199802771

Metrics

23 Record Views

243 Times Cited - Web of Science

See more details