IS TRANSCRANIAL DOPPLER SONOGRAPHY USEFUL IN DETECTING LATE CEREBRAL-ISCHEMIA AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

Transcranial Doppler (TCD) examination was performed in 109 patients w ith aneurysmal subarachnoid haemorrhage. Fifty-seven demonstrated flow velocities exceeding 120 cm/s in the middle cerebral artery. Of these , 23 developed delayed ischaemic deficit (DID). Mean flow velocity in this group was 170, SD 12.8 cm/s, in comparison with 155, SD 11.2 cm/s in the 34 patients without late signs of cerebral ischaemia. This dif ference is significant (p = 0.0269). :In the 34 patients without DID, but TCD > 120 cm/s, 17 received anti-ischaemic therapy based on TCD va lues only, while 17 were given no additional treatment. The mean TCD v alues and the neurological outcome in the two groups were similar. A r apid increase in flow velocities of 50 cm/s or more during a 24-h peri od seemed to be a strong predictor of symptomatic vasospasm as seven o ut of 12 patients developed DID, five with permanent neurological sequ elae. The study confirms results from other centres, that a strict cor relation between high TCD flow velocities and the occurrence of DID do es not exist.