Early abnormal transient hyperemic response test can predict delayed ischemic neurologic deficit in subarachnoid hemorrhage

Critical Ultrasound Journal
Hosam Al-JehaniJeanne Teitelbaum

Abstract

Early detection of vasospasm is crucial to prevent significant delayed ischemic neurological deficit post subarachnoid hemorrhage. The standard methods of detection, including cerebral angiogram and computed tomography are invasive and not safe to be repeated, as is very often indicated clinically. Transient hyperemic response test has been previously used to predict autoregulation failure in traumatic brain injury and subarachnoid hemorrhage. We investigate the usability of transient hyperemic response test as a predictor of clinical vasospasm in a cohort of patients with aneurismal subarachnoid hemorrhage. A retrospective review of all THRT examinations done between January 2011 and July 2012 conducted at Montreal Neurological Institute and Hospital and the Montreal General Hospital. Patients diagnosed with aSAH in which the THRT was performed within the first 24-48 h of admission were included in the study. Two-dimensional transcranial Doppler images were obtained and velocities were recorded. A positive response was one in which the velocity was increased by more than 9% of the baseline systolic velocity, indicating an intact cerebral autoregulation. Lindegaard ratio > 3 is considered abnormal and in the context of elevated...Continue Reading

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Citations

Sep 10, 2019·Asian Journal of Neurosurgery·Vitor Nagai YamakiEberval Gadelha Figueiredo
Jun 8, 2018·Critical Ultrasound Journal·Achyut Sharma, Diptesh Aryal
May 29, 2018·Case Reports in Neurological Medicine·Hosam Al-JehaniJeanne Teitelbaum
Mar 27, 2021·Physiological Reviews·Jurgen A H R ClaassenFrank M Faraci
Aug 10, 2021·Frontiers in Neurology·Darcy LidingtonSteffen-Sebastian Bolz

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