Relationship between transcranial doppler and CT data in acute CT intracerebral hemorrhage

ABSTRACT

It would be useful to have a noninvasive test for correlation with CT findings in patients with intracerebral hemorrhage [ICH]. We determined which transcranial Doppler [TCD] variables are related to CT data in patients with ICH. We included 51 patients [age +/- SD, 66.2 +/- 12.4 years; 30 men, 21 women] with first-ever supratentorial, nontraumatic ICH. CT and TCD examination were performed in the acute stage [less than 12 hours from symptom onset]. TCD recordings were obtained from the middle cerebral arteries, and the following variables were analyzed systolic [Vs], diastolic [Vd], mean [Vm] velocities, and pulsatiliy index [PI] from the affected [a] and unaffected [u] hemispheres. PIs obtained for both hemispheres were positively correlated with hematoma volume [aPI, r = 0.43, P = .001; uPI, r = 0.44, P = .001], volume of hypoattenuation [aPI r = 0.64, P <.0001; uPI, r = 0.39, P = .005], total volume [aPI, r = 0.59, P <.0001; uPI, r = 0.48, P < .0001], and midline shift [aPI, r = 0.28, P = .04; uPI, r = 0.29, P = .03]. Both PIs were increased in patients with intraventricular hemorrhage [aPI, P = .01; uPl P .004]. No TCD parameter was correlated with ventricular size. Most TCD parameters were correlated with CT data in the acute stage of ICH. An increase in PI probably reflects intracranial hypertension and mass effect. Further studies are needed to determine the clinical application of our findings: