Diagnosis and monitoring of subarachnoid hemorrhage by transcranial color-coded real-time sonography.
Thirty-six patients with acute spontaneous subarachnoid hemorrhage (26 caused by rupture of an aneurysm) were examined by transcranial color-coded real-time sonography by using a 2.25-MHz ultrasound transducer. In 20 of these 26 patients (76%), the aneurysm could be identified by a characteristic abnormal blood flow pattern within the aneurysm in coronal and axial scanning planes by transcranial color-coded real-time sonography. Blood within the basal cisterns, on top of the tentorium, and within the ventricles and parenchyma was sonographically detected by increased echodensity in 75%. In addition, cerebrospinal fluid circulation disturbances and cerebral vasospasm were detected in two-dimensional B-mode images in 85% and 100%, respectively. In Doppler mode, intravascular blood flow velocity could be quantified. We conclude that transcranial color-coded real-time sonography, a new, noninvasive method for diagnosis and follow-up of patients with subarachnoid hemorrhage, allows detection of the primary vascular lesion and monitoring of complications.
Becker
G
G
Department of Neurology, Julius-Maximilians Universität Würzburg, Federal Republic of Germany.
Greiner
K
K
Kaune
B
B
Winkler
J
J
Brawanski
A
A
Warmuth-Metz
M
M
Bogdahn
U
U
D001783:Blood Flow Velocity; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology; D002560:Cerebrovascular Circulation; D003116:Color; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography