Evaluation of Application Value of Transcranial Doppler (TCD) in the Inspection of Cerebral Vasospasm After the Treatment of Intracranial Aneurysm

Abstract

Objective This study aimed to explore the application value of transcranial doppler (TCD) in the inspection of cerebral vasospasm (CVS) after the treatment of intracranial aneurysm.Methods: 105 cases of patients with confirmed intracranial aneurysm were divided into two groups based on the two different treatments - craniotomy and aneurysmal clipping or interventional emboli-zation therapy. TCD was applied to monitor the conditions of CVS of 105 cases, and case study re-search method was used to analyze and conclude the TCD inspection data of patients with intracrani-al aneurysm detected after operation.Results: The sensitivity of TCD in the detection of CVS was 83% and the specificity was 88%. Fur-ther, the incidence rate of CVS in the group treated with interventional embolization therapy was higher than that of the group treated with aneurysm clipping.Conclusions: TCD, which can be used to guide the adjustment of treatment and avoid complications, is an effective method in monitoring CVS after the treatment of intracranial aneurysm.

Manejo bimodal de aneurismas asociados a malformaciones arteriovenosas cerebrales. Reporte de caso y breve revisión de la literatura

“…Tiene una sensibilidad del 83% y una especificidad del 88%, y es de mayor utilidad en el clipaje de aneurismas que en su tratamiento endovascular. Se ha descrito que velocidades de flujo de 120-140 cm/s, 140-200 cm/s y > 200 cm/s en la arteria cerebral media 18 , que es donde se ubicaba el transductor utilizado en nuestro caso, son concordantes con vasoespasmo leve, moderado y grave, respectivamente. Durante nuestro procedimiento se mantuvo en 50-58 cm/s antes, durante y posterior al clipaje.…”

Application of transcranial Doppler in cerebrovascular diseases

“…There is a direct correlation between the severity of VSP after SAH and the blood velocity in cerebral arteries. TCD contributes to monitoring the angiography of VSP after SAH to guide the timing of diagnostic and therapeutic angiographic interventions; specifically, the CBV in the MCA and VA was measured to obtain a more accurate detection result of VSP ( Wang et al, 2018 ; Santos-Teles et al, 2019 ; Roa et al, 2020 ).…”

Commentary: Posterior Reversible Encephalopathy Syndrome as a Complication of Induced Hypertension in Subarachnoid Hemorrhage: A Case-Control Study

“…This choice is debatable, as cerebral vasculature evaluation by TCD can reveal simple and reliable to assess the response to the therapeutics, and also help to define therapeutic targets, as MAP and CO, especially in patients under neuroprotective sedation or comatose patients. 13 In the study, IH therapy was continued for relatively long duration, with clinical evaluation as the only criterion of evaluation of IH therapy efficiency. A multimodal monitoring could permit to target lower MAP, and/or shorter duration of IH therapy and maybe to avoid PRES.…”