Is Transcranial Doppler Ultrasonography Old-fashioned?: One Institutional Validity Study

ABSTRACT

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 1st TCD test and 3rd 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%. Conclusion: 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.