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Transcranial Doppler in Subarachnoid Hemorrhage: Usefulness in the Diagnosis and Monitoring of Cerebral Vasospasm

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Neurosonology in Critical Care

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Abstract

Transcranial Doppler ultrasonography, performed by experienced sonographers, is a noninvasive, flexible, accessible, and accurate tool for the bedside monitoring of cerebral flow and treatment response. Identification of the intracranial vessels is based on: velocity and direction, depth of signal, spatial relationship with other vessels, and response to ipsilateral and contralateral carotid compression. One of the main fields of clinical application of transcranial sonography is assessment and monitoring of cerebral vasospasm, which is a common complication of subarachnoid hemorrhage (SAH). Mean flow velocities of these vessels are directly proportional to flow and inversely proportional to the section of the vessel. Any situation that leads to a variation of one of these factors can thus affect mean velocities. Following peak systolic and mean blood flow velocities of the vessel in its whole length is mandatory. Additional information about systemic or circulatory conditions that may affect blood flow velocities should be gained, and vasospasm ratios (Lindegaard, Soustiel, and Sloan) should be used within the framework of a strict ultrasound monitoring protocol.

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Authors and Affiliations

  1. University Hospital and Medical Faculty, Department of Clinical Neurosciences, LUNIC Laboratory, Neurocenter of Geneva, Geneva, Switzerland

    Fabienne Perren

  2. Committee Member - ESNCH, Olso, Norway

    Fabienne Perren

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  1. Fabienne Perren
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Correspondence to Fabienne Perren .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Buenos Aires, Buenos Aires, Argentina

    Camilo N. Rodríguez

  2. Stroke Unit & Neurosonology Lab, University of Padua School of Medicine, Padova, Italy

    Claudio Baracchini

  3. Department of Critical Care and Anesthesiology, Fundación Valle del Lili, Cali, Colombia

    Jorge H. Mejia-Mantilla

  4. Department of Clinical Neurosciences Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK

    Marek Czosnyka

  5. Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jose I Suarez

  6. President of Hungarian Neurological Society, Department of Neurology, Clinical Center Debrecen University, Debrecen, Hungary

    László Csiba

  7. Intensive Care Unit, Clinics Hospital, Universidad de la Republica School of Medicine, Montevideo, Uruguay

    Corina Puppo

  8. Center for Neurological Vascular Diagnostics, Munich, Germany

    Eva Bartels

Algorithm

Algorithm

figure a

ABCD Airway-breathing-circulation-disability, CTA CT Angiography, MRA MRI Angiography, DSA digital subtraction angiography

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Perren, F. (2022). Transcranial Doppler in Subarachnoid Hemorrhage: Usefulness in the Diagnosis and Monitoring of Cerebral Vasospasm. In: Rodríguez, C.N., et al. Neurosonology in Critical Care . Springer, Cham. https://doi.org/10.1007/978-3-030-81419-9_22

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  • DOI: https://doi.org/10.1007/978-3-030-81419-9_22

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