Is Transcranial Doppler Ultrasonography Old-fashioned?: One Institutional Validity Study.
OBJECTIVE
The purpose of this study is to investigate the correlation between various transcranial Doppler (TCD) ultrasonography parameters and clinical vasospasm after aneurysmal subarachnoid hemorrhage (SAH).


METHODS
This study enrolled 40 patients presented with aneurysmal SAH between September 2006 and August 2007. We measured differences of mean blood flow velocity (BFVm), highest systolic blood flow velocity (BFVh), and Lindegaard ratio (LR) in the middle cerebral artery on TCD examination. These parameters were evaluated for correlation with clinical vasospasm by univariate analysis and the receiver operating characteristic analysis.


RESULTS
Twelve patients (30%) developed clinical vasospasm. The best TCD parameters for the detection of clinical vasospasm were revealed to be differences of BFVm, BFVh, and LR values between 1(st) TCD test and 3(rd) TCD (7 cm/s, 11.5 cm/s, 0.45 respectively). The positive predictive value of any one of three parameters was 60% and the negative predictive value was 100%.


CONCLUSIONS
TCD is still considered a useful tool for screening clinical vasospasm. To confirm the predictive value of the above parameters, further prospective study will be needed.
Han
Pan Yeal
PY
Department of Neurosurgery, School of Medicine, Eulji University, Nowon Eulji Hospital, Seoul, Korea.
Kim
Jae Hoon
JH
Kang
Hee In
HI
Moon
Byung Gwan
BG
Lee
Seung Jin
SJ
Kim
Joo Seung
JS