Value of Perfusion CT, Transcranial Doppler Sonography, and Neurological Examination to Detect Delayed Vasospasm after Aneurysmal Subarachnoid HemorrhageReportar como inadecuado




Value of Perfusion CT, Transcranial Doppler Sonography, and Neurological Examination to Detect Delayed Vasospasm after Aneurysmal Subarachnoid Hemorrhage - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Radiology Research and PracticeVolume 2012 2012, Article ID 231206, 6 pages

Research Article

Department of Neurosurgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany

Department of Neuroradiology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany

Department of Neuroradiology, Universitt Würzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany

Received 6 May 2012; Accepted 16 August 2012

Academic Editor: David Maintz

Copyright © 2012 Ekkehard Kunze et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.





Autor: Ekkehard Kunze, Mirko Pham, Furat Raslan, Christian Stetter, Jin-Yul Lee, Laszlo Solymosi, Ralf-Ingo Ernestus, Giles Hamilt

Fuente: https://www.hindawi.com/



DESCARGAR PDF




Documentos relacionados