NORMALIZATION OF TRANSCRANIAL DOPPLER MIDDLE CEREBRAL-ARTERY VELOCITIES AFTER ANEURYSM CLIPPING

BACKGROUND Factors that promote normalization of middle cerebral arter y (MCA) velocities after cerebral aneurysm surgery may be important to identify in order to optimize management. Survival analysis of serial transcranial Doppler (TCD) MCA velocities in the setting of aneurysm surgery offers an additional means of analyzing outcome. METHODS We re trospectively studied serial MCA velocities obtained via TCD in 113 pa tients who underwent cerebral aneurysm clipping to analyze which facto rs promoted normalization. The presence of bleeding, aneurysm location , age, gender, ethnicity, initial blood pressure, hemoglobin, and clin ical condition were examined. RESULTS Patients who did not bleed but w ere clipped still tended to have transient periods of abnormally eleva ted velocities. Of those patients who bled and were clipped, order pat ients normalized faster. Women showed a trend toward slower normalizat ion only in the subarachnoid hemorrhage (SAH) absent group. Other para meters listed above did not effect normalization time. CONCLUSIONS Our data suggest aneurysm surgery in and of itself may promote transient rises in MCA velocities. Age appears to be a significant factor in pre dicting normalization of MCA velocities after SAH. (C) 1997 by Elsevie r Science Inc.