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[Transcranial Doppler and cerebral vasospasm].

F Cattin¹, J F Bonneville

¹Département de Neuroradiologie Hôpital Jean-Minjoz, Besançon.

Journal of Neuroradiology = Journal De Neuroradiologie

|June 11, 1999

Summary

Transcranial Doppler ultrasound detects vasospasm by measuring increased blood flow velocities in cerebral arteries. Elevated velocities, particularly over 200 cm/sec, indicate potential ischemia and predict poor outcomes.

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Area of Science:

Neurology
Medical Imaging
Ultrasound Technology

Background:

Cerebral vasospasm is a critical complication following subarachnoid hemorrhage.
Transcranial Doppler (TCD) ultrasound is a non-invasive method to assess cerebral blood flow dynamics.

Purpose of the Study:

To evaluate the correlation between transcranial Doppler ultrasound flow velocities and symptomatic cerebral vasospasm.
To establish the diagnostic utility of TCD in identifying and quantifying vasospasm.

Main Methods:

Utilized pulsed Doppler probes via the transtemporal approach for TCD examinations.
Employed transcranial color-coded real-time sonography to identify cerebral arteries.
Analyzed maximum flow velocities and rates of velocity change over time.

Main Results:

Increased flow velocities in basal arteries correlate with symptomatic vasospasm.
Velocities exceeding 200 cm/sec are associated with cerebral ischemia and infarction.
A rise of >50 cm/sec/24h indicates a poor prognosis; TCD in the middle cerebral artery shows 87% positive predictive value at 130 cm/sec.

Conclusions:

TCD is a valuable tool for diagnosing cerebral vasospasm.
Specific velocity thresholds can predict ischemia, infarction, and patient outcomes.
Factors like intracranial pressure and blood pressure can influence TCD findings, necessitating careful interpretation.

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