Transcranial Doppler(TCD) Monitoring In The Clinical Application Of Cerebral Vasospasm After Subarachnoid Hemorrhage

Objective : By Transcranial Doppler(TCD) after subarachnoid hemorrhage(SAH)dynamic monitoring of intracranial vascular blood flow velocity of specific, clear the feasibility of TCD monitoring of intracranial vasospasm after SAH, and thus provide a reference basis for subsequent treatment.Methods: Dalian municipal central hospital were retrospectively analyzed between January 2013 and December 2013, neurosurgery admitted during the period of 40 patients with subarachnoid hemorrhage, TCD monitoring after admission,(since the onset, 12 hours, 24 hours, 48 hours after three days, five days, 7 days, ten days, 14 days time point monitoring, including preoperative and postoperative monitoring), and for each patient synchronous digital subtraction angiography(DSA) inspection(complete)within 72 hours after admission. Respectively according to patients’ age, gender, history of high blood pressure, smoking history, CT- Fisher grouping classification and grade of Hunt- Hess, and carries on the statistical analysis for the data from each group,specifically for significant differences between groups vasospasm after SAH. The comparison of various parameters using t test; The percentage said count data contrast to take Chi square check, P > 0.05 for no statistically significant difference, P < 0.05 for the difference is significant.Results: 1. 40 patients, confirmed by TCD monitoring of 31 cases with vascular spasm,confirmed by DSA examination of 33 patients with vascular spasm, TCD found vasospasm positive rate was 77.5%, DSA found that the positive rate of the vasospasm was 82.5%, there is no significant difference(P>0.05)2. Confirmed by TCD monitoring of cerebral vasospasm after subarachnoid hemorrhage has obvious regularity, which began to appear in 12 to 48 hours after admission vasospasm. 7-10 days vasospasm peak, 12-14 days vasospasm3. This experimental study based on patients’ gender, age, smoking history,hypertension history factors that affect the degree of cerebral vascular spasm, tube is analyzed, indicates that the above factors and cerebral vasospasm is no clear correlation.(P > 0.05)4. Confirmed by this study CT- Fisher grade level and the seriousness of vasospasm is a clear correlation, therefore, CT- Fisher classification on diagnostic accuracy CVS has important clinical significance.(P <0.05)5. Hunt- Hess classification and the severity of cerebral vasospasm there is no clear correlation. It also suggests that Hunt- Hess classification in the prediction of cerebral vasospasm in poor reliability.Conclusion: By Transcranial Doppler(TCD) is a kind of new tools for monitoring cerebral vasospasm, is also a kind of non-invasive bedside tool. Have a safe noninvasive,simple operation and repeatability, convenient and quick, and the price is low wait for an advantage. Can be used to real-time monitoring of cerebral artery blood flow velocity,and judge the Cerebrovascular spasm after SAH, on prevention in CVS after SAH the adverse consequences of early diagnosis and treatment, is the ideal auxiliary examination equipment of neurosurgery.