Vasospasm after SAH due to aneurysm rupture of the anterior circle of Willis: value of TCD monitoring

Abstract Objective: The aim of this study was to verify the presence of angiographic vasospasmin patients with transcranial Doppler(TCD) of high velocities after subarachnoid hemorrhage(SAH). Methods: Seven hundred and eighty-six cases admitted within 48 hours after SAH due to the rupture of anterior circulation aneurysm, were prospectively studied with TCD. In cases of TCD velocities higher than 120 cm/s (TCD vasospasm), the patient underwent a control angiography. Hunt–Hess and Fisher's grade on admission CT and location of the aneurysm were related to occurrence of TCD vasospasm. The increase in TCD velocities within 24 hours was calculated and related to the presence of cerebral ischemia on discharge CT, considering three groups of patients: Group A with an increase in velocities higher than 60%, Group B with an increase in velocities between 30 and 60%, and Group C with an increase in velocities lower than 30%. Results: TCD vasospasmwas observed in 216 patients (27%). In 97% of patients with TCD ...