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 -