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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2003

01-07-2003 | Original

The accuracy of transcranial Doppler to detect vasospasm in patients with aneurysmal subarachnoid hemorrhage

Authors: L. Mascia, L. Fedorko, K. terBrugge, C. Filippini, M. Pizzio, V. M. Ranieri, M. C. Wallace

Published in: Intensive Care Medicine | Issue 7/2003

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Abstract

Objectives

To examine the accuracy of transcranial Doppler to detect cerebral vasospasm in a patient population with aneurysmal subarachnoid hemorrhage.

Design

Prospective blind comparison of transcranial Doppler with cerebral angiography. Diagnostic accuracy of transcranial Doppler was assessed using receiver operating characteristic (ROC) analysis and likelihood ratios. Sensitivity and specificity were calculated using directly measured middle cerebral artery diameter as reference standard.

Setting

Intensive Care Unit of a large university teaching hospital.

Patients and participants

Twenty-two patients with subarachnoid hemorrhage were included. Patients underwent angiography on admission and after 8 days to diagnose vasospasm and were defined as having clinical vasospasm, angiographic vasospasm, or no vasospasm.

Measurements and results

Sensitivity and specificity were 1.00 and 0.75 for angiographic vasospasm and both equal to 1.00 for clinical vasospasm diagnosis. A transcranial Doppler mean velocity threshold value of 100 cm/s for angiographic vasospasm and 160 cm/s for clinical vasospasm detection were chosen by ROC analysis.

Conclusions

A Transcranial Doppler mean velocity threshold of 160 cm/s, calculated by the ROC analysis, accurately detects clinical vasospasm. A daily transcranial Doppler examination performed by a trained operator should be routinely used to provide early identification of patients at high risk and to orient therapeutic decisions.
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Metadata
Title
The accuracy of transcranial Doppler to detect vasospasm in patients with aneurysmal subarachnoid hemorrhage
Authors
L. Mascia
L. Fedorko
K. terBrugge
C. Filippini
M. Pizzio
V. M. Ranieri
M. C. Wallace
Publication date
01-07-2003
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 7/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-1780-5

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