TRANSCRANIAL DOPPLER ULTRASOUND IN HYPERTENSIVE VERSUS NORMOTENSIVE PATIENTS AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

Background and Purpose Arterial hypertension is a negative prognostic risk factor after aneurysmal subarachnoid hemorrhage (SAH). Transcrani al Doppler ultrasound is commonly used for measuring blood flow veloci ties to predict cerebral ischemia due to vasospasm after SAH. Our purp ose was to evaluate the influence of arterial hypertension on blood fl ow velocities in the cerebral circulation after aneurysmal SAH. Method s With transcranial Doppler ultrasound we compared the brood flow velo cities in matched groups of hypertensive and normotensive patients wit h aneurysmal SAH. Twenty-four patients with arterial hypertension were examined daily during a 2-week period. As controls, 24 normotensive p atients, also with SAH, were matched by age, sex, neurological status, and clinical outcome. Results Minimum, mean and maximum flow velociti es in the middle cerebral artery in the hypertensive patients were sig nificantly lower than in the normotensive individuals, with P=.02 for minimum, P=.02 for mean, and P=.02 for maximum. There was no statistic al significance for pulsatility index differences in these groups (P=. 45). Diastolic notch was noted in two of the hypertensive and in six o f the normotensive patients. Conclusions The results indicate that eve n moderately increased flow velocities in hypertensive patients may re present significant vasospasm.