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Journal of Intensive Care Medicine
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0885066608318516v1
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Article

Role of Transcranial Doppler in Optimizing Treatment of Cerebral Vasospasm in Subarachnoid Hemorrhage

Ribal S. Darwish, MD1*, Edwarde Ahn, MD2, and Nana S. Amiridze, MD, Ph.D.3

1 Dept of Anesthesiology, Critical Care Medicine
2 Dept of Neuosurgery
3 University of Maryland School of Medicine, Dept of Diagnostic Radiology and Nuclear Medicine

* To whom correspondence should be addressed. E-mail: rdarwish{at}anes.umm.edu.


  Abstract
This study was undertaken to evaluate the role of transcranial Doppler ultrasonography in arterial blood pressure management during hypervolemia/hypertension/ hemodilution therapy in patients with vasospasm from subarachnoid hemorrhage and correlate this data with neurologic outcome. The study included 18 adult patients, Hunt and Hess grades III-IV. Complete neurologic assessment was performed. Transcranial Doppler indices were calculated by standard formulas. On the basis of our results, resistance area product can be used to estimate the optimal arterial blood pressure in hypervolemia/hypertension/hemodilution therapy. An increase in the cerebral blood flow index was associated with better performance on neurologic examination. Estimated cerebral perfusion pressure from transcranial Doppler data analysis showed poor correlation with cerebral perfusion pressure derived from direct measurement of intracranial pressure in patients with cerebral vasospasm ({rho} = 0.15; 95% CI, 0.11-0.39; P = .2590).

First published on May 13, 2008, doi:10.1177/0885066608318516

Journal of Intensive Care Medicine 2008;23:263.

A more recent version of this article appeared on July 1, 2008

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