Brain SPECT and transcranial doppler ultrasound in vasospasm-induced delayed cerebral ischemia after subarachnoid hemorrhage

D H Lewis; S Hsu; J Eskridge; W Cohen; R Dalley; D Newell; C Douville; G Pendleton; C H Chestnut 3rd; H R Winn

doi:10.1016/S1052-3057(10)80029-1

Brain SPECT and transcranial doppler ultrasound in vasospasm-induced delayed cerebral ischemia after subarachnoid hemorrhage

J Stroke Cerebrovasc Dis. 1992;2(1):12-21. doi: 10.1016/S1052-3057(10)80029-1. Epub 2010 Jun 11.

Authors

D H Lewis¹, S Hsu², J Eskridge¹, W Cohen¹, R Dalley¹, D Newell², C Douville², G Pendleton², C H Chestnut 3rd¹, H R Winn²

Affiliations

¹ From the Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, U.S.A.
² The Department of Neurological Surgery, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, U.S.A.

PMID: 26486429
DOI: 10.1016/S1052-3057(10)80029-1

Abstract

Clinical vasospasm, or delayed ischemia-related neurologic deficits, is the prime determinant of morbidity and mortality after subarachnoid hemorrhage. The diagnosis of clinical vasospasm has been based mainly on clinical observations. Noninvasive techniques for evaluating vasospasm have great promise in supplementing the detailed neurologic examination and assessing the effects of therapy. The clinical utility of single-photon emission computed tomography (SPECT) of regional cerebral blood flow and transcranial Doppler ultrasound (TCD) in the evaluation of cerebral vasospasm after subarachnoid hemorrhage was reviewed in 40 patients. The combination of these noninvasive tests was valuable for the investigation of the dynamic anatomic and functional aspects of vasospasm. TCD proved helpful in monitoring for vascular narrowing by measurements of blood flow velocity. Brain SPECT ascertained the effects of vasospasm on regional cerebral blood flow. In the diagnosis of clinical vasospasm, or delayed ischemic deficits, brain SPECT was more sensitive and specific than TCD. The combination of SPECT and TCD was useful in the assessment of the effect of cerebral angioplasty on hemodynamics and perfusion in the attempt to avert infarction.