title: Embolic signals during routine transcranial Doppler ultrasonography in aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Cerebral emboli may occur in subarachnoid hemorrhage (SAH) and intracranial aneurysm surgery. Although embolic signs (ES) have been reported in SAH, their origin remains unclear. The aim of this study was to report the detection of ES during routine TCD monitoring in patients with aneurysmal SAH.
  
  
  METHODS
  A total of 105 patients with aneurysmal SAH were submitted to TCD evaluation. Patients were monitored almost daily (5 times per week). In each monitoring session, one experienced operator performed TCD to detect or assess vasospasm and ES in arteries of the Willis polygon.
  
  
  RESULTS
  Four patients out of a total of 105 patients with aneurysmal SAH were found to present spontaneous cerebral embolization during routine TCD monitoring. The average age of the 4 patients (mean ± standard deviation) was 59.5 ± 8.34 years (range 49-68 ys); female patients predominated representing 75% (3/4) of subjects.
  
  
  CONCLUSIONS
  Although detection of ES was relatively rare in this study, rates of emboli occurrence may be higher under systematic monitoring. The detection of ES after SAH surgery reinforces the need to study the role of embolus in this condition and may be an indicator for prophylactic antithrombotic treatment.
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Fernando Mendes
authors.initials: FM
authors.lastname: Paschoal
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Karla
authors.initials: K
authors.lastname: de Almeida Lins Ronconi
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: de Lima Oliveira
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Ricardo de Carvalho
authors.initials: Rde C
authors.lastname: Nogueira
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Eric Homero Albuquerque
authors.initials: EH
authors.lastname: Paschoal
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
authors.affiliation: Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Neurological Surgery, Hospital das Clinicas, Sao Paulo University Medical School, 04040-001 Sao Paulo, SP, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Bor-Seng-Shu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004617:Embolism / Q000000981:diagnostic imaging*; D005260:Female; D005343:Fibrinolytic Agents / Q000737:chemistry; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging*; D017585:Ultrasonography, Doppler, Transcranial; D020301:Vasospasm, Intracranial / Q000473:pathology; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents