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

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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

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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.
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