Transcranial doppler grading criteria for basilar artery vasospasm

Gill E. Sviri, Basavaraj Ghodke, Gavin W. Britz, Colleen M. Douville, David R. Haynor, Ali H. Mesiwala, Arthur M. Lam, David W. Newell

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

OBJECTIVE: Transcranial Doppler (TCD) criteria for basilar artery (BA) vasospasm are poorly defined, and grading criteria for vertebrobasilar vasospasm are unavailable. The purpose of the present study was to define TCD grading criteria for BA vasospasm on the basis of the absolute flow velocities and the intracranial to extracranial flow velocity ratios for the posterior circulation, and to improve the sensitivity and specificity of TCD for diagnosis of BA vasospasm. METHODS: One hundred twenty-three patients with aneurysmal subarachnoid hemorrhage underwent 144 cerebral arteriograms with views of the BA during the acute phase of vasospasm (Days 3-14 after hemorrhage). BA diameters were measured and compared with diameters obtained from baseline arteriograms. Both BA and extracranial vertebral artery flow velocities were measured by TCD within 4 hours before the arteriogram. RESULTS: The velocity ratio between the BA and the extracranial vertebral arteries (VA) strongly correlated with the degree of BA narrowing (r = 0.648; P < 0.0001). A ratio higher than 2.0 was associated with 73% sensitivity and 80% specificity for BA vasospasm. A ratio higher than 2.5 with BA velocity greater than 85 cm/s was associated with 86% sensitivity and 97% specificity for BA narrowing of more than 25%. A BA/VA ratio higher than 3.0 with BA velocities higher than 85 cm/s was associated with 92% sensitivity and 97% specificity for BA narrowing of more than 50%. CONCLUSION: The BA/VA ratio improves the sensitivity and specificity of TCD detection of BA vasospasm. On the basis of the BA/VA ratio and BA mean velocities, we suggest new TCD grading criteria for BA vasospasm.

Original languageEnglish (US)
Pages (from-to)360-365
Number of pages6
JournalNeurosurgery
Volume59
Issue number2
DOIs
StatePublished - Aug 2006

Keywords

  • Aneurysm
  • Angiography
  • Basilar artery
  • Subarachnoid hemorrhage
  • Transcranial doppler
  • Vasospasm

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Fingerprint Dive into the research topics of 'Transcranial doppler grading criteria for basilar artery vasospasm'. Together they form a unique fingerprint.

Cite this