Transcranial Doppler sonography within 12 hours after subarachnoid hemorrhage

Twenty-one patients were subjected to repeated assessment of cerebral blood flow velocities by means of transcranial Doppler sonography (TCDS) during the first 12 hours after subarachnoid hemorrhage (SAH). In 19 patients the study was performed following the first SAH, and in two after early rebleeds. Flow velocities did not indicate an early phase of arterial narrowing in any case. Following the first TCDS assessment, flows were evaluated repeatedly in the 19 survivors. Increased flow velocities suggesting arterial narrowing or vasospasm occurred only after a delay of at least 4 days. The results of this study favor the restoration of normal velocity patterns in surviving patients and do not indicate that an acute phase of vasospasm exists either immediately after or in the first 12 hours after SAH.