Transcranial Doppler velocity and associations with delayed cerebral ischemia in aneurysmal subarachnoid Hemorrhage
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Updated: Dec 18, 2025
Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound
Published on: June 3, 2021
Jason J Chang1, Matthew Triano2, Maite J Corbin2
1Department of Critical Care Medicine. MedStar Washington Hospital Center. Washington, DC, USA.; Department of Neurology. Georgetown University Medical Center. Washington, DC, USA..
Background And Purpose:
We evaluated optimal transcranial Doppler (TCD) measures for predicting delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH).
Material And Methods:
Consecutive patients with aSAH and daily middle cerebral artery (MCA) TCD recordings were retrospectively analyzed. Change in TCD velocity was obtained by creating a smoothing curve. Change in TCD velocity was determined with a linear regression model that confirmed greatest change in velocity associated with DCI occurred at days 2-7. Multivariate logistic regression analysis was then completed.
Results:
95 patients were evaluated. Increase in TCD velocity at days 2-7 proved to be the best predictor for DCI with an optimal cutoff of 8.9 cm/s/day (p = .019) and AUC 0.651. Multivariate logistic regression analysis using DCI as outcome showed that poor admission Hunt-Hess scores (OR 5.02, 95%CI 1.22-22.67, p = .028) and increases in TCD velocity (OR 5.32, 95%CI 1.41-23.33, p = .018) were independently associated with DCI.
Conclusions:
We found that relative increases in TCD velocities in the MCAs during the first 7 days (with a threshold increase of 53.4 cm/s from days 2 to 7) after aSAH admission were independently associated with DCI. This association requires independent confirmation.
