Transcranial Doppler Criteria For Predicting Symptomatic Cerebral Vasospasm And Analysis Of Risk Factors Of Symptomatic Cerebral Vasospasm

PurposeTo study the criteria of transcranial doppler (TCD) for predicting symptomatic cerebral vasospasm after clipping of aneurysm with onset of spontaneous subarachnoid hemorrhage to increase the accuracy of prediction and analyze the risk factors of symptomatic cerebral vasospasm for predicting symptomatic cerebral vasospasm better.Methodwe analyzed retrospectively 46 patients who suffered aneurysmal subarachnoid hemorrhage and received clipping operation in our hospital from April 1,2008 to March 1,2010. Receiptor operation curve (ROC) was used to find the highest diagnostic accuracy TCD for symptomatic cerebral vasospasm and corresponding middle cerebral artery peak flow velocity(MCA-FV). Logistic regression analysis was used to analyze the risk factors of symptomatic cerebral vasospasm.ResultsMCA-FV=160cm/s had the highest accuracy of prediction with sensitivity of 92.3% and specificity of 42.4%. Modified Fisher grade(OR=3.271,P=0.015) and MCA-FV>160cm/s (OR=10.246,P=0.044) had significant correlation with symptomatic vasospasm, while age(P=0.843), gender(P=0.608), Hunt-Hess grade(P=0.201), WFNS grade (P=0.214) and Fisher grade (P=0.202) had no statistical correlation with symptomatic vasospasm.ConclusionTCD had the highest accuracy of prediction using the threshold of MCA-FV=160cm/s. MCA-FV≥160cm/s and Modified Fisher grade were significant risk factors of symptomatic cerebral vasospasm. The probability of occurrence of symptomatic cerebral vasospasm is greater in MCA-FV≥160cm/s than in MCA-FV≤160cm/s. The higher the modified Fisher grade was, the greater probability of occurrence of symptomatic cerebral vasospasm had.