JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (11): 38-41.doi: 10.6040/j.issn.1671-7554.0.2017.223

Previous Articles     Next Articles

A clinical analysis of transcranial Doppler in predicting delayed cerebral ischemia after ruptured aneurysm surgery

WANG Moulong1, CHEN Yongkun2, XING Deguang3, QU Liangsuo1, WANG Chengwei3   

  1. 1. Department of Neurosurgery, Central Hospital of Shandong Energy Zibo Mining Group Co., Ltd, Zibo 255120, Shandong, China;
    2. Department of Ultrasound, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China;
    3. Department of Neurosurgery, Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2017-03-16 Online:2017-11-10 Published:2017-11-10

PDF (PC)

61

Abstract: Objective To evaluate the sensibility of transcranial Doppler(TCD)in predicting delayed cerebral ischemia(DCI)after ruptured aneurysm surgery, and to explore the risk factors of DCI. Methods Clinical data of 67 patients with ruptured aneurysm who received intracranial aneurysmal clipped operation were retrospectively analyzed. Receiver operator characteristic curve(ROC)and Logistic regression were adopted to analyze the diagnostic accuracy and risk factors of DCI. Results DCI occurred in 18 of all patients, with an incidence rate of 26.9%. When the middle cerebral artery mean blood flow velocity(MCAVm)was 149.5 cm/s, TCD had the highest predicting accuracy, and the sensitivity and specificity were 88.9% and 81.6%, respectively. Modified Fisher grade and MCAVm≥130 cm/s were significantly correlated with the occurrence of DCI. Conclusion Early dynamic TCD monitoring can effectively predict DCI, guide the treatment and reduce the ischemic neurological deficits. Modified Fisher grade and MCAVm≥130 cm/s are the risk factors of DCI.

Key words: Delayed cerebral ischemia, Arterial aneurysm, Subarachnoid hemorrhage, Transcranial Doppler, Microsurgery

CLC Number: 

  • R737.31
[1] Kumar G, Shahripour RB, Harrigan MR. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis[J]. J Neurosurg, 2016, 124(5): 1257-1264.
[2] Jabbarli R, Reinhard M, Shah M, et al. Early vasospasm after aneurysmal subarachnoid hemorrhage predicts the occurrence and severity of symptomatic vasospasm and delayed cerebral ischemia[J]. Cerebrovasc Dis, 2016, 41(5-6): 265-272.
[3] Marsh EB, Ziai WC, Llinas RH. The need for a rational approach to vasoconstrictive syndromes: transcranial Doppler and calcium channel blockade in reversible cerebral vasoconstriction syndrome[J]. Case Rep Neurol, 2016, 8(2): 161-171.
[4] Wong GK, Nung RC, Sitt JC, et al. Location, infarct load, and 3-month outcomes of delayed cerebral infarction after aneurysmal subarachnoid hemorrhage[J]. Stroke, 2015, 46(11): 3099-3104.
[5] Sun J, Tan G, Xing W, et al. Optimal hemoglobin concentration in patients with aneurysmal subarachnoid hemorrhage after surgical treatment to prevent symptomatic cerebral vasospasm[J]. Neuroreport, 2015, 26(5): 263-266.
[6] Saito A, Inoue M, Kon H, et al. Effectiveness of intraarterial administration of fasudil hydrochloride for preventing symptomatic vasospasm after subarachnoid hemorrhage[J]. Acta Neurochir Suppl, 2015, 120: 297-301. doi: 10.1007/978-3-319-04981-6_50.
[7] Frontera JA, Fernandez A, Schmidt JM, et al. Defining vasospasm after subarachnoid hemorrhage: what is the most clinically relevant definition?[J]. Stroke, 2009, 40(6): 1963-1968.
[8] Baggott CD, Aagaard-Kienitz B. Cerebral vasospasm[J].Neurosurg Clin N Am, 2014, 25(3): 497-528.
[9] Rao GS, Muthuchellappan R. Cerebral vasospasm: current understanding[J]. Curr Opin Anaesthesiol, 2016, 29(5): 544-551.
[10] Kohama M, Sugiyama S, Sato K, et al. Difference in transcranial Doppler velocity and patient age between proximal and distal middle cerebral artery vasospasms after aneurysmal subarachnoid hemorrhage[J]. Cerebrovasc Dis Extra, 2016, 6(2): 32-39.
[11] Ehrlich G, Kirschning T, Wenz H, et al. Is there an influence of routine daily transcranial Doppler examination on clinical outcome in patients after aneurysmal subarachnoid hemorrhage?[J]. World Neurosurg, 2016, 88: 214-221. doi: 10.1016/j.wneu.2015.11.091.
[12] Platz J, Güresir E, Wagner M, et al. Increased risk of delayed cerebral ischemia in subarachnoid hemorrhage patients with additional intracerebral hematoma[J]. J Neurosurg, 2017, 126(2): 504-510.
[1] XU Kai, HAN Chao, DING Shouluan, DING Xuan, XING Deguang, WANG Chengwei. Factors of preoperative rebleeding in 181 patients with poor-grade aneurysmal subarachnoid hemorrhage [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 97-101.
[2] REN Baoxin, MA Yunfeng, LIU Dianwei, LI Zhuo, JIANG Yong. Effects of Wnt3a on neuronal autophagy and apoptosis in early brain injury after subarachnoid hemorrhage in rats [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 11-15.
[3] CHENG Li, ZHANG Chuanbin, LI Meng, ZHANG Yuzhen, SUN Jinlong. Anti-fibrosis role of miR-29c in rat leptomeninge after experimental subarachnoid hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(4): 22-25.
[4] LI Bing, FEI Chang, GUO Feng, SUN Aigang, HUAN Linchun, GUO Shouzhong, LIU Yuhai. Microsurgical treatment of brain arteriovenous malformation in cerebral functional areas assisted with electro-magnetic navigation and ultrasound [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(4): 80-82.
[5] ZHANG Jie, WANG Zhigang, WANG Yihua, JIANG Bin, HE Wei, YIN Xin, GUO Wenqiang. Clinical characteristics and treatment of intracranial arteriovenous malformation in children with acute hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(2): 56-60.
[6] LI Zhuo1, JIANG Huili2, LIU Dianwei2, XIE Jie1, JIANG Yong2. Effects of Wnt3a on the neurogenesis in rats during early brain  injury after subarachnoid hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(5): 15-19.
[7] MENG Fan-liang1， MENG Lei2, PENG Hong-hai2, SHI Jian-guo2, LIU Dian-wei2, JIANG Yong2. Effects of interferon-β on cardiopulmonary function after
subarachnoid hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(5): 32-35.
[8] ZHAO Yong-hui1, Gao Jun2, LI Zhuo1, JIANG Yong2. Protective effects of progesterone on early brain injury in
rats after subarachnoid hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(5): 55-.
[9] ZHANG Yin-li1, Ji Zhong-guo1, ZHANG Ying-rui2. Relationship between the cognitive function level and cerebral
hemodynamics in patients with leukoaraiosis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(2): 57-.
[10] ZHENG Nan1,2, JI Yong3, SUN Ruo-peng1. Expressions of ICAM-1, NF-κB and p38MAPK
in the hippocampus of rabbits after SAH [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(10): 28-32.
[11] WAGN Guo-jun， LI Xin-gang. Microsurgical treatment for medial sphenoid wing meningiomas [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(1): 105-.
[12] WU Da-hao, WANG Chang-zhen， XU Shang-chen, PANG Qi. Modified operation and comprehensive analysis of diagnosis and management of medulloblastoma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(1): 101-.
[13] JI Yong, WANG Zhi-gang, WANG Cheng-wei, ZHANG Qing-lin . Expressions of p38MAPK, NF-κB, ICAM-1 after SAH and  their relations with the cause of CVS  [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(7): 65-.
[14] GUO Jin-hui1, JIANG Yong2. Effect of Xingnaojing on apoptosis of hippocampal neurons in  rats with  subarachnoid hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(7): 57-60.
[15] ZHANG Lei, LI Xingang, LI Gang, XU Shujun, WANG Donghai, WANG Xinyu, ZHAO Peng, LI Xueen. Microsurgical treatment for craniopharyngioma: analysis of 59 cases [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(7): 122-125.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] WANG Huan-liang,SUN Bao-zhu,DU Hong-mei,ZHOU Chang-qing,ZHANG Li. Controlling the depth of propofol anesthesia using the bispectral indexand the systolic blood pressure[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(5): 471 -474 .
[2] HUANGQing,TIAN Hui,LI Lin,LIANG Fei,LIU Xi-xian. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(6): 556 -559 .
[3] ZHU Mei-jia,HAN Ju,WANG Xin-yi,LU Wei,WANG Ai-hua,GUAN Xin-hua,CAO Xia,CAO Bing-zhen. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(8): 834 -839 .
[4] SONG Hai-yan, WU Yu-ling, ZHANG Yan-ping. Protective effect of oyster extract on apoptotic cells in neural tube defect induced by hyperthermia[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(2): 113 -116 .
[5] ZENG Ji-ping,WANG Li-na,WANG Li-xiang,REN Xiao-hui,ZHANG Meng-ye,XIA Wen,CUI Xing. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(5): 467 -470 .
[6] SHU Ya,QI Feng. Jaw thrust device (JTD) on obesity patients for maintaining the airway patency during general anesthesia induction[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(10): 1072 -1074 .
[7] YU Hui1,2, CHEN Shaohua1, ZHAO Jiajun2, GAO Ling3
. Effects of ethanol on glycogen content, GSK3β，
and PAMPK of L02 cells[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(04): 75 -78 .
[8] WANG Zhi-ang,DING Xua,SUN Peng/sup>,WANG Cheng-wei,HAO Xiao-guang,PAN Shun. Role of pre-operative cerebral angiography in cerebral artery stenosis stent angioplasty[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(2): 146 -148 .
[9] SONG Yong-hong,MA Chun-hong,LV Hong-juan,ZHU Chuan-fu,NIE Xiang-min,WANG Mei,LIU Yan,ZHANG Ping. HLA allele polymorphism in northern Hans of China[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(6): 546 -553 .
[10] ZHANG Xiang-li,LIU Feng-ying. Correlation between serum TPA and sVCAM-1 and pathogenesis of pre-eclampsia[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(7): 705 -707 .
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd