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The accuracy of transcranial Doppler to detect vasospasm in patients with aneurysmal subarachnoid hemorrhage.
- Source :
- Intensive Care Medicine; Jul2003, Vol. 29 Issue 7, p1088-1094, 7p
- Publication Year :
- 2003
-
Abstract
- <bold>Objectives: </bold>To examine the accuracy of transcranial Doppler to detect cerebral vasospasm in a patient population with aneurysmal subarachnoid hemorrhage.<bold>Design: </bold>Prospective blind comparison of transcranial Doppler with cerebral angiography. Diagnostic accuracy of transcranial Doppler was assessed using receiver operating characteristic (ROC) analysis and likelihood ratios. Sensitivity and specificity were calculated using directly measured middle cerebral artery diameter as reference standard.<bold>Setting: </bold>Intensive Care Unit of a large university teaching hospital.<bold>Patients and Participants: </bold>Twenty-two patients with subarachnoid hemorrhage were included. Patients underwent angiography on admission and after 8 days to diagnose vasospasm and were defined as having clinical vasospasm, angiographic vasospasm, or no vasospasm.<bold>Measurements and Results: </bold>Sensitivity and specificity were 1.00 and 0.75 for angiographic vasospasm and both equal to 1.00 for clinical vasospasm diagnosis. A transcranial Doppler mean velocity threshold value of 100 cm/s for angiographic vasospasm and 160 cm/s for clinical vasospasm detection were chosen by ROC analysis.<bold>Conclusions: </bold>A Transcranial Doppler mean velocity threshold of 160 cm/s, calculated by the ROC analysis, accurately detects clinical vasospasm. A daily transcranial Doppler examination performed by a trained operator should be routinely used to provide early identification of patients at high risk and to orient therapeutic decisions. [ABSTRACT FROM AUTHOR]
- Subjects :
- INTRACRANIAL aneurysm ruptures
CEREBRAL hemorrhage
ARTERIAL injuries
ANGIOGRAPHY
BRAIN blood-vessels
MEDICAL radiography
CEREBRAL vasospasm
COMPARATIVE studies
RESEARCH methodology
MEDICAL cooperation
RESEARCH
SUBARACHNOID hemorrhage
TRANSCRANIAL Doppler ultrasonography
EVALUATION research
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 29
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 16629486
- Full Text :
- https://doi.org/10.1007/s00134-003-1780-5