Comparison of Transcranial Doppler Investigation of Aneurysmal Vasospasm with Digital Subtraction Angiographic and Clinical Findings

Okada, Yoshikazu; Shima, Takeshi; Nishida, Masahiro; Yamane, Kanji; Hatayama, Takashi; Yamanaka, Chie; Yoshida, Akira

doi:10.1097/00006123-199909000-00005

Cited by 62 publications

(23 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tolonen reported in 1981 increased regional CCTs in ischemic brain hemispheres of 183 acute stroke patients by 99m-Technetium scintigraphy [6]. In more recent angiographic studies, a prolonged global CCT was shown to be associated with cerebral vasospasm after aneurysmal subarachnoid haemorrhage [7, 8]which can be reversed by intraarterial papaverine infusion [9]. A further clinical application of a regional angiographic CCT in cerebral AVM, analysing contrast in- and outflow pattern of the feeding and draining AVM vessels is currently under investigation [10, 11].…”

Section: Discussionmentioning

confidence: 99%

Measurement of Global Cerebral Circulation Time Using Power Duplex Echo-Contrast Bolus Tracking

Schreiber

Kauert²,

Doepp³

et al. 2003

Cerebrovasc Dis

View full text Add to dashboard Cite

Ultrasound assessment of global cerebral circulation time (CCT) using echo-contrast bolus tracking is a new approach to characterise the perfusion status of the human brain. We present the analysis of global CCT in 36 healthy volunteers and one patient with a cerebral arteriovenous malformation (AVM), measured by extracranial power duplex. CCT was defined as the time interval between bolus arrival in the internal carotid artery and internal jugular vein. CCT in the volunteer group was 7.5 ± 1.1 s (mean ± SD). Values did not correlate with age, gender, blood pressure or blood flow velocity. Measurement in the AVM patient revealed a CCT of 1.5 s. Ultrasonographic CCT analysis is a promising new tool for the evaluation of cerebral hemodynamics.

show abstract

Section: Discussionmentioning

confidence: 99%

Measurement of Global Cerebral Circulation Time Using Power Duplex Echo-Contrast Bolus Tracking

Schreiber

Kauert²,

Doepp³

et al. 2003

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…39,40 Patients were considered to have vasospasm if there was evidence of arterial narrowing compared with the normal vessel caliber (mild Ͻ30%, moderate 30% to 60%, or severe 61% to 99%) as determined by 1 of 3 attending neurointerventional radiologists. Follow-up CT scans in a subset of 235 subjects were reviewed by a trained stroke neurologist (N.U.K., P.R.).…”

Section: Measurement Of Vasospasm and Clinical Risk Factorsmentioning

confidence: 99%

Endothelial Nitric Oxide Synthase Polymorphism (−786T→C) and Increased Risk of Angiographic Vasospasm After Aneurysmal Subarachnoid Hemorrhage

Rajendran

Kim

et al. 2008

Stroke

View full text Add to dashboard Cite

Background and Purpose-Vasospasm after aneurysmal subarachnoid hemorrhage (SAH) remains a leading cause of death and disability after aneurysm rupture. Decreased availability of nitric oxide (NO) may be crucial in its pathogenesis. We hypothesized that endothelial NO synthase (eNOS) polymorphisms may determine susceptibility to vasospasm in SAH patients. Methods-We conducted a prospective cohort study of SAH patients and determined vasospasm by cerebral angiography.We genotyped 3 eNOS polymorphisms: an intron 4 variable-number tandem-repeat, a promoter single-nucleotide polymorphism (Ϫ786T3 C SNP), and a coding SNP in exon 7 (894G3 T encoding E298D). Using multivariable logistic regression, we quantified the association of eNOS polymorphisms in patients with vasospasm confirmed by cerebral angiography. Results-For the eNOS promoter Ϫ786T3 C SNP, the presence of the CC genotype compared with any T genotype (CT or TT) was associated with increased odds of vasospasm (odds ratioϭ2.97, 95% CIϭ1.32 to 6.67, Pϭ0.008). No association with vasospasm was observed for the eNOS 894G3 T or variable-number tandem-repeat polymorphisms. Conclusions-These findings suggest that genetic variation influencing NO regulation contributes to the risk of angiographic vasospasm in patients with SAH. The specific role of the promoter SNP (Ϫ786T3 C) may determine the effect of NO regulated by this pathway, distinct from other known eNOS polymorphisms.

show abstract

“…We eventually analyzed data from 26 studies. [3][4][5]7,10,11,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] An exact quantification of the number of included patients and the number of tests performed was impossible, because there was inconsistency in reporting these numbers in the original studies. We contacted the main authors of 2 studies by letter to clarify queries about the reported data, but we did not receive any answer.…”

Section: Included and Excluded Trialsmentioning

confidence: 99%

Transcranial Doppler Versus Angiography in Patients With Vasospasm due to a Ruptured Cerebral Aneurysm

Lysakowski¹,

Walder²,

Costanza³

et al. 2001

Stroke

379

195

View full text Add to dashboard Cite

Background and Purpose-Transcranial Doppler (TCD) is used for diagnosis of vasospasm in patients with subarachnoid hemorrhage due to a ruptured aneurysm. Our aim was to evaluate both the accuracy of TCD compared with angiography and its usefulness as a screening method in this setting. Methods-A search (MEDLINE, EMBASE, Cochrane Library, bibliographies, hand searching, any language, through January 31, 2001) was performed for studies comparing TCD with angiography. Data were critically appraised using a modified published 10-point score and were combined using a random-effects model. Results-Twenty-six reports compared TCD with angiography. Median validity score was 4.5 (range 1 to 8). Metaanalyses could be performed with data from 7 trials. For the middle cerebral artery (5 trials, 317 tests), sensitivity was 67% (95% CI 48% to 87%), specificity was 99% (98% to 100%), positive predictive value (PPV) was 97% (95% to 98%), and negative predictive value (NPV) was 78% (65% to 91%). For the anterior cerebral artery (3 trials, 171 tests), sensitivity was 42% (11% to 72%), specificity was 76% (53% to 100%), PPV was 56% (27% to 84%), and NPV was 69% (43% to 95%). Three of these 7 studies reported on the same patients, each on another artery, and for 4, data recycling could not be disproved. Other arteries were tested in only 1 trial each. Conclusions-For the middle cerebral artery, TCD is not likely to indicate a spasm when angiography does not show one (high specificity), and TCD may be used to identify patients with a spasm (high PPV). For all other situations and arteries, there is either lack of evidence of accuracy or of any usefulness of TCD. Most of these data are of low methodological quality, bias cannot not be ruled out, and data reporting is often uncritical. (Stroke. 2001;32:2292-2298.)

show abstract

Comparison of Transcranial Doppler Investigation of Aneurysmal Vasospasm with Digital Subtraction Angiographic and Clinical Findings

Cited by 62 publications

References 26 publications

Measurement of Global Cerebral Circulation Time Using Power Duplex Echo-Contrast Bolus Tracking

Measurement of Global Cerebral Circulation Time Using Power Duplex Echo-Contrast Bolus Tracking

Endothelial Nitric Oxide Synthase Polymorphism (−786T→C) and Increased Risk of Angiographic Vasospasm After Aneurysmal Subarachnoid Hemorrhage

Transcranial Doppler Versus Angiography in Patients With Vasospasm due to a Ruptured Cerebral Aneurysm

Contact Info

Product

Resources

About