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Updated: Jun 24, 2026

The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects
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Author Response: Before the Stump Flow on the TCD in SAH can be Attributed to an SAH Relapse all Other Possible

Ripenmeet Salhotra1

  • 1Department of Anesthesia and Critical Care, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Faridabad, Haryana, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|January 30, 2025
PubMed

Insights

Before attributing stump flow on transcranial Doppler (TCD) in subarachnoid hemorrhage (SAH) to a relapse, all other potential causes must be excluded. This ensures accurate diagnosis and appropriate patient management.

Area of Science:

  • Neurocritical care
  • Cerebrovascular diseases
  • Diagnostic imaging

Background:

  • Subarachnoid hemorrhage (SAH) can lead to delayed cerebral ischemia.
  • Transcranial Doppler (TCD) is used to monitor cerebral blood flow.
  • Stump flow on TCD can be an indicator of potential complications.

Purpose of the Study:

  • To emphasize the critical need to rule out alternative causes before attributing stump flow to SAH relapse.
  • To highlight the diagnostic challenges in interpreting TCD findings in SAH patients.

Main Methods:

  • This is an author response, not a primary research study.
  • Discussion based on clinical experience and existing literature regarding SAH complications and TCD interpretation.

Main Results:

  • Stump flow on TCD in SAH patients is not pathognomonic for SAH relapse.
  • Various conditions can mimic the TCD findings suggestive of SAH relapse.

Conclusions:

  • A comprehensive differential diagnosis is essential when stump flow is observed on TCD in SAH.
  • Attributing stump flow solely to SAH relapse without excluding other causes can lead to misdiagnosis and inappropriate treatment.

Keywords:
Doppler ultrasoundNeurocritical careSubarachnoid hemorrhageTranscranial DopplerTranscranial ultrasound

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