title: Computed tomography and transcranial Doppler findings in acute and subacute phases of intracerebral hemorrhagic stroke.
abstract: OBJECTIVE
  The hematoma volume is an important determinant of outcome and a predictor of clinical deterioration in patients with intracerebral hemorrhage (ICH). Our goal was to evaluate alterations in the cerebral circulation, in respect to hemorrhage and edema volume changes, using transcranial Doppler (TCD).
  
  
  METHODS
  Twenty patients with acute supratentorial ICH were examined. Brain, hematoma, and edema volumes were calculated from CT scans performed at admission and 2 weeks later. Data were compared with those obtained from bilateral TCD recordings of the middle cerebral arteries.
  
  
  RESULTS
  During TCD examination, blood flow velocities did not change, cerebral perfusion pressure (CPP) and resistance area product (RAP) decreased (P = .006, P = .002) while cerebral blood flow index (CBFI) remained constant on the affected side. Although hemorrhage volume did not correlate with RAP in the acute phase, correlation was found in the subacute phase (r = -.44, P = .04).
  
  
  CONCLUSIONS
  TCD monitoring sensitively demonstrates the hemodynamic change caused by ICH but the severity of the changes does not correlate with the volume of the ICH in acute stage. The CPP, RAP, and CBFI values are more sensitive parameters than the absolute velocity values, therefore they contribute more to the understanding of hemodynamic changes developed after spontaneous ICH.
authors: Department of Anesthesiology and Intensive Care, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
authors: Béla
authors: B
authors: Fülesdi
authors: Katalin
authors: K
authors: Réka Kovács
authors: Dániel
authors: D
authors: Bereczki
authors: Péter
authors: P
authors: Bágyi
authors: István
authors: I
authors: Fekete
authors: László
authors: L
authors: Csiba
mesh_terms: D001783:Blood Flow Velocity; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
keywords: Cerebral hemodynamics; computed tomography; intracerebral hemorrhage; transcranial ultrasound