Association of Different Transcranial Doppler-derived Indices of Cerebrovascular Dynamics With Delayed Cerebral Ischemia in Patients Suffering From Subarachnoid Hemorrhage: A Retrospective Study
Background
Cerebral vasospasm (VS) and delayed cerebral ischemia (DCI) constitute major complications following subarachnoid hemorrhage (SAH). A few studies have examined the relationship between different indices of cerebrovascular dynamics with the occurrence of VS. However, their potential association with the development of DCI remains elusive. In this study, we investigated the pattern of changes of different transcranial doppler-derived indices of cerebrovascular dynamics during vasospasm in patients suffering from subarachnoid hemorrhage, dichotomized by the presence of delayed cerebral ischemia.
Methods
A retrospective analysis was performed using recordings from 32 SAH patients, diagnosed with VS. Patients were divided in 2 groups, depending on development of DCI. Magnitude of slow waves (SWs) of cerebral blood flow velocity (CBFV) and arterial blood pressure was measured.
Cerebral autoregulation was estimated using the moving correlation coefficient Mxa. Cerebral arterial time constant (tau) was expressed as the product of resistance and compliance.
Results
In the whole population (N=32), magnitude of SWs of ipsilateral CBFV was increased during vasospasm (4.15 ± 1.55 vs before: 2.86 ± 1.21 cm/sec, p < 0.001). Ipsilateral SWs of CBFV before VS had higher magnitude in DCI group (p < 0.001) and were strongly predictive of DCI, with area under the curve = 0.745, p = 0.009. VS caused shortening of tau (ipsilateral to spasm: 0.17 ± 0.08 vs before: 0.25 ± 0.17 sec, p = 0.04) and interhemispheric asymmetry with lower values on ipsilateral side (p < 0.01). In patients with DCI (N=19), Mxa was increased during VS (ipsilateral to spasm: 0.36 ± 0.18 vs before: 0.26 ± 0.23, p = 0.04).
Conclusions
In the whole group of patients, VS was associated with increased CBFV SWs in both temporal and spatial assessments. Greater SWs before VS in DCI group, were strongly predictive of DCI.
Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Received 08 Feb, 2021
On 28 Jan, 2021
Invitations sent on 27 Jan, 2021
On 27 Jan, 2021
On 26 Jan, 2021
On 26 Jan, 2021
On 26 Jan, 2021
Posted 12 Nov, 2020
On 09 Jan, 2021
Received 28 Dec, 2020
Received 28 Dec, 2020
On 05 Dec, 2020
On 09 Nov, 2020
Invitations sent on 08 Nov, 2020
On 04 Nov, 2020
On 04 Nov, 2020
On 04 Nov, 2020
On 03 Nov, 2020
Association of Different Transcranial Doppler-derived Indices of Cerebrovascular Dynamics With Delayed Cerebral Ischemia in Patients Suffering From Subarachnoid Hemorrhage: A Retrospective Study
Received 08 Feb, 2021
On 28 Jan, 2021
Invitations sent on 27 Jan, 2021
On 27 Jan, 2021
On 26 Jan, 2021
On 26 Jan, 2021
On 26 Jan, 2021
Posted 12 Nov, 2020
On 09 Jan, 2021
Received 28 Dec, 2020
Received 28 Dec, 2020
On 05 Dec, 2020
On 09 Nov, 2020
Invitations sent on 08 Nov, 2020
On 04 Nov, 2020
On 04 Nov, 2020
On 04 Nov, 2020
On 03 Nov, 2020
Background
Cerebral vasospasm (VS) and delayed cerebral ischemia (DCI) constitute major complications following subarachnoid hemorrhage (SAH). A few studies have examined the relationship between different indices of cerebrovascular dynamics with the occurrence of VS. However, their potential association with the development of DCI remains elusive. In this study, we investigated the pattern of changes of different transcranial doppler-derived indices of cerebrovascular dynamics during vasospasm in patients suffering from subarachnoid hemorrhage, dichotomized by the presence of delayed cerebral ischemia.
Methods
A retrospective analysis was performed using recordings from 32 SAH patients, diagnosed with VS. Patients were divided in 2 groups, depending on development of DCI. Magnitude of slow waves (SWs) of cerebral blood flow velocity (CBFV) and arterial blood pressure was measured.
Cerebral autoregulation was estimated using the moving correlation coefficient Mxa. Cerebral arterial time constant (tau) was expressed as the product of resistance and compliance.
Results
In the whole population (N=32), magnitude of SWs of ipsilateral CBFV was increased during vasospasm (4.15 ± 1.55 vs before: 2.86 ± 1.21 cm/sec, p < 0.001). Ipsilateral SWs of CBFV before VS had higher magnitude in DCI group (p < 0.001) and were strongly predictive of DCI, with area under the curve = 0.745, p = 0.009. VS caused shortening of tau (ipsilateral to spasm: 0.17 ± 0.08 vs before: 0.25 ± 0.17 sec, p = 0.04) and interhemispheric asymmetry with lower values on ipsilateral side (p < 0.01). In patients with DCI (N=19), Mxa was increased during VS (ipsilateral to spasm: 0.36 ± 0.18 vs before: 0.26 ± 0.23, p = 0.04).
Conclusions
In the whole group of patients, VS was associated with increased CBFV SWs in both temporal and spatial assessments. Greater SWs before VS in DCI group, were strongly predictive of DCI.
Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3