TY - JOUR A2 - Maintz, David AU - Kunze, Ekkehard AU - Pham, Mirko AU - Raslan, Furat AU - Stetter, Christian AU - Lee, Jin-Yul AU - Solymosi, Laszlo AU - Ernestus, Ralf-Ingo AU - Vince, Giles Hamilton AU - Westermaier, Thomas PY - 2012 DA - 2012/09/24 TI - Value of Perfusion CT, Transcranial Doppler Sonography, and Neurological Examination to Detect Delayed Vasospasm after Aneurysmal Subarachnoid Hemorrhage SP - 231206 VL - 2012 AB - Background. If detected in time, delayed cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) may be treated by balloon angioplasty or chemical vasospasmolysis in order to enhance cerebral blood flow (CBF) and protect the brain from ischemic damage. This study was conceived to compare the diagnostic accuracy of detailed neurological examination, Transcranial Doppler Sonography (TCD), and Perfusion-CT (PCT) to detect angiographic vasospasm. Methods. The sensitivity, specificity, positive and negative predictive values of delayed ischemic neurological deterioration (DIND), pathological findings on PCT-maps, and accelerations of the mean flow velocity (MVF) were calculated. Results. The accuracy of DIND to predict angiographic vasospasm was 0.88. An acceleration of MFV in TCD (>140 cm/s) had an accuracy of 0.64, positive PCT-findings of 0.69 with a higher sensitivity, and negative predictive value than TCD. Interpretation. Neurological assessment at close intervals is the most sensitive and specific parameter for cerebral vasospasm. PCT has a higher accuracy, sensitivity and negative predictive value than TCD. If detailed neurological evaluation is possible, it should be the leading parameter in the management and treatment decisions. If patients are not amenable to detailed neurological examination, PCT at regular intervals is a helpful tool to diagnose secondary vasospasm after aneurysmal SAH. SN - 2090-1941 UR - https://doi.org/10.1155/2012/231206 DO - 10.1155/2012/231206 JF - Radiology Research and Practice PB - Hindawi Publishing Corporation KW - ER -