title: Microemboli in aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  The determinants of ischemic complications in subarachnoid hemorrhage (SAH) are not well defined. The objective of this study is to evaluate the role of microemboli in SAH-related cerebral ischemia.
  
  
  METHODS
  Forty patients with aneurysmal SAH were monitored with transcranial Doppler (TCD) for the presence of embolic signals (ES) and vasospasm, and followed clinically for the development of cerebral ischemic symptoms, from the time the aneurysm was secured until day 14 posthemorrhage or discharge.
  
  
  RESULTS
  Microembolic signals were detected in 15/40 patients, appeared at a mean of 6.7 days after hemorrhage, and were often noted bilaterally. There was a close association between ES and cerebral ischemic symptoms (P= .003), and ES were commonly present in the distribution of the vessel with ischemic symptoms. Ultrasonographic vasospasm did not correlate with ischemia and there was no relationship between microembolic signals and vasospasm.
  
  
  CONCLUSIONS
  In this study, ES detected in over a third of SAH victims, were associated with the development of cerebral ischemic symptoms, and were not related to vasospasm, but rather appeared to be an independent risk factor for the development of ischemic symptoms in SAH.
authors.affiliation: Department of Neurology, University of Miami, Miami, FL, USA. jromano@med.miami.edu
authors.forename: Jose G
authors.initials: JG
authors.lastname: Romano
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
authors.forename: Sandra
authors.initials: S
authors.lastname: Nathan
authors.forename: Iszet
authors.initials: I
authors.lastname: Campo-Bustillo
authors.forename: Sebastian
authors.initials: S
authors.lastname: Koch
authors.forename: Alejandro M
authors.initials: AM
authors.lastname: Forteza
mesh_terms: D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000628:therapy; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy; D013525:Surgical Instruments; D017585:Ultrasonography, Doppler, Transcranial; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging* / Q000628:therapy