TRANSCRANIAL DOPPLER DIAGNOSIS OF CEREBRAL VASOSPASM FOLLOWING SUBARACHNOID HEMORRHAGE - CORRELATION AND ANALYSIS OF RESULTS IN RELATION TOTHE AGE OF PATIENTS

A retrospective analysis was undertaken to determine whether cerebral vasospasm following subarachnoid haemorrhage (SAH) correlates with the age of patients. For at least 3 weeks after bleeding 80 subjects unde rwent very close follow-up with clinical examination and transcranial Doppler records of the blood velocities within the basal cerebral arte ries. Firstly a correlation between measured maximal mean blood flow v elocities and age was made. Secondly, according to their age and the m aximum of recorded mean velocitites (v), the patients were divided int o groups as follows: age 55 years or less, age more than 55 years; and maximum velocity vl < 90 cm/s, 90 cm/s < v2 < 120 cm/s, 120 cm/s < v3 < 160 cm/s, v4 > 160 cm/s. There was a significant correlation of the measured maximum mean velocities and the age of the patients (r = -0. 525, p < 0.01). With regard to the velocity groups there was a signifi cant (chi-squared statistic for contingency tables, p < 0.01) differen ce between both age-groups: 32% (n = 18) of the younger fell into grou p v4 with maximum mean velocities of more than 160 cm/s, but none of t he older had such. Vice versa, 63% (n = 15) of the older compared with only 14% (n = 8) of the younger fell into group vl with maximum mean velocities of less than 90 cm/s. Clinical follow-up also depicted diff erences between both age groups. 13 of 18 younger patients with maximu m mean velocities > 160 cm/s exhibited symptomatic vasospasm with a de layed neurological deficit. This typical course did not occur in the o lder age group. We conclude from this analysis that the increase of bl ood velocity in the basal cerebral arteries following subarachnoid hae morrhage depends on the age of the patient. Furthermore, young patient s will be more prone to a delayed ischaemic deficit. On the other hand , older patients may also suffer ischaemic deficits following subarach noid haemorrhage but often without measurable vasospasm according to t ranscranial Doppler criteria and without the typical delayed appearanc e.