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  Česky / Czech version Čes. a slov. Neurol. Neurochir., 68/101, 2005, No. 4, p. 212–217.
 
Predictive Significance of Transcranial Duplex Sonography in the Diagnostics of Delayed Ischaemic Deficit in Patients with Spontaneous Subarachnoid Haemorrhage 
Bar M.1, Školoudík D.1, Hradílek P.1, Zapletalová O.1, Paleček T.2, Kosek V.3 

1Neurologická klinika FNsP Ostrava, 2Neurochirurgická klinika FNsP Ostrava, 3Oddělení statistických analýz FNsP Ostrava
 


Summary:

       According to current data from transcranial Doppler ultrasound the risk of developing delayed ischaemic deficit (DID) increases when the mean flow velocity (V mean) is higher than 160cm/s, or daily V mean grows by 50cm/s. In our work we have prospectively assessed the differences of ultrasound findings between groups of patients with and without DID. The influence of clinical status in the beginning of subarachnoid haemorrhage (SAH) in Hunt – Hess scale and the amount of blood at computed tomography on the final outcome in Rankin scale were also followed. Fifty-eight patients with SAH were enrolled during a threeyears’ period. There were performed four consequent transcranial duplex examinations (TCCS). The following parametres were recorded: maximum flow velocity, end diastolic velocity, resistence index in the middle cerebral artery, anterior cerebral artery and posterior cerebral artery, and flow volume in the ipsilateral internal carotid artery. Statistical significance was tested with paired sample t-test and Pearson’s coefficient. The admission and any follow up CT scans were reviewed by a neuroradiologist and neurologist. The DID diagnosis was established on basis of finding parenchymal low – density area in 27 cases (44.9 %). There were found statistically significant differences in maximum systolic velocity between a group of patients with symptomatic vasospasm and without (p<0.05). We have found that the amount of blood at CT and entry clinical status influenced the rise of DID (p<0.001). The increase of resistence index above 0.65 affected the patients’ outcome negatively (p<0.001).

        Key words: subarachnoid haemorrhage, vasospasm, ultrasound, delayed ischaemic deficit, outcome
       

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