ANGIOGRAPHIC AND DOPPLER DIAGNOSIS OF CEREBRAL-ARTERY VASOSPASM FOLLOWING SUBARACHNOID HEMORRHAGE

Angiographic middle and anterior cerebral artery diameter and transcra nial ultrasound flow velocity measurements were performed within 24 h of each other in 102 patients with recent aneurysmal subarachnoid haem orrhage. There was a significant inverse correlation between middle ce rebral artery diameter and flow velocity (r=-0.54, p<0.001). No such c orrelation was seen for anterior cerebral arteries (r=-0.25). The rati o of middle cerebral artery to extracranial internal carotid artery ve locities, which is an index of vasospasm, did not show improved correl ation with arteriographic diameters, compared with uncorrected middle cerebral artery readings. Middle and anterior cerebral artery velociti es and diameters both began to show significant changes indicative of vasospasm from day 4-5 onwards, suggesting that an increase in Doppler velocity is a good indicator of middle cerebral artery diameter, as s hown by angiography. These studies indicate that transcranial Doppler is a useful non-invasive monitor for the development of delayed vasosp asm following subarachnoid haemorrhage.