Decreased Flow Velocity with Transcranial Color-Coded Duplex Sonography Correlates with Delayed Cerebral Ischemia due to Peripheral Vasospasm of the Middle Cerebral Artery

Sadahiro, Hirokazu; Shirao, Satoshi; Yanagawa, Hiroshi; Ishihara, Hideyuki; Oku, Takayuki; Inamura, Akinori; Yamane, Akiko; Sugimoto, Kazutaka; Fujiyama, Yuichi; Suzuki, Michiyasu

doi:10.1016/j.jstrokecerebrovasdis.2016.05.032

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…reported that peripheral MCA spasms do not increase the flow velocity but rather decrease it. [ 15 ] A similar phenomenon could occur in this case. CTA or angiogram is recommended on days 6–8, and this case should have been examined with proper precautions against infection as a DCI high-risk case.…”

Section: Discussionsupporting

confidence: 74%

Early recanalization and vasospasm after endovascular treatment in a case of ruptured vertebral artery dissecting aneurysm associated with COVID-19

Nakamura,

Takashima,

Nonaka

et al. 2023

Surgical Neurology International

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Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant structural changes in acute care hospitals. COVID-19-associated stroke has gained attention, with abnormal coagulation and vascular endothelial damage being recognized. While ischemic cases are commonly reported, hemorrhagic cases have also been reported. This report presents a case of ruptured vertebral artery dissection aneurysm associated with COVID-19, resulting in subarachnoid hemorrhage (SAH). The treatment course, challenges in managing cerebral vasospasm, and early recanalization achieved through endovascular therapy are described. Case Description: A 67-year-old male patient was brought to our hospital for emergency treatment of impaired consciousness that occurred while recovering from COVID-19. He underwent endovascular internal trapping using coils, and although the rupture did not recur, he required long-term tracheal management, which resulted in a cerebral infarction caused by cerebral vasospasm. In addition, early recanalization was seen, which required retreatment. Conclusion: This case highlights the challenges in managing COVID-19-associated SAH and emphasizes the need for infection control measures and proper postoperative care. Establishing protocols for detecting and managing cerebral vasospasm is essential.

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Section: Discussionsupporting

confidence: 74%

Early recanalization and vasospasm after endovascular treatment in a case of ruptured vertebral artery dissecting aneurysm associated with COVID-19

Nakamura,

Takashima,

Nonaka

et al. 2023

Surgical Neurology International

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“…Early detection of DCI is an important step in the way of the improvement of the outcome and the survival of aSAH patients. Transcranial duplex (TCD) is a non-invasive modality which can assess the cerebral blood vessels diameters and flow velocities that can be a useful maneuver in early detection of vasospasm after aSAH [5] . Electroencephalogram (EEG) is another sensitive early detector of disturbed neuronal activity due to the reduced cerebral blood flow evidenced by focal slowing of the background activities [6].…”

Section: Introductionmentioning

confidence: 99%

Vasospasm following aneurysmal subarachnoid hemorrhage: prediction, detection, and intervention

Nassar

Ghali

Bahnasy

et al. 2019

Egypt J Neurol Psychiatry Neurosurg

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BackgroundVasospasm of the cerebral blood vessels is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) which results in delayed cerebral ischemia (DCI) and worsening of the outcome.MethodsThis study was performed on 41 aSAH patients diagnosed by non-contrast brain CT, CT angiography, and digital subtraction angiography followed by interventional aneurysmal embolization. Patients were followed up for 20 days by clinical assessment, EEG monitoring, and transcranial duplex studies (TCD) for early detection of vasospasm and DCI.ResultsThe most common ruptured aneurysmal sites were middle cerebral, anterior communicating, posterior communicating, terminal internal carotid, and anterior cerebral arteries respectively. The incidence of vasospasm was 36.8% of the included cases; 57% progressed to DCI while 43% passed a spontaneous regressive course. The most common arteries undergoing vasospasm were the MCA followed by the ACA, ICA, and lastly the basilar arteries. The mean time of vasospasm development as detected by EEG monitoring and/or TCD was 8.4 ± 2.8 days which was earlier than clinical signs by 12.5 ± 5.3 h in those progressed to DCI.ConclusionContinuous EEG monitoring and TCD are valuable methods for early detection of vasospasm and they allow for early therapeutic intervention before irreversible ischemic neurological deficits take place.

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“…However, TCD is incapable of intuitively reflecting the structural morphology of cerebral vessels. It only indirectly reflects the state of the vasculature via examination of the blood flow velocity at the sampling points; however, the velocity of the blood flow itself is affected by many physiological factors ( 31 ). Moreover, due to the inadequate acoustic window, TCD has certain limitations in the diagnosis of cerebrovascular diseases.…”

Section: Ultrasound In Cerebral Arterial Occlusionmentioning

confidence: 99%

Research progress in ultrasound use for the diagnosis and treatment of cerebrovascular diseases

Li¹,

Zhou²,

Zheng³

et al. 2019

Clinics

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Cerebrovascular diseases pose a serious threat to human survival and quality of life and represent a major cause of human death and disability. Recently, the incidence of cerebrovascular diseases has increased yearly. Rapid and accurate diagnosis and evaluation of cerebrovascular diseases are of great importance to reduce the incidence, morbidity and mortality of cerebrovascular diseases. With the rapid development of medical ultrasound, the clinical relationship between ultrasound imaging technology and the diagnosis and treatment of cerebrovascular diseases has become increasingly close. Ultrasound techniques such as transcranial acoustic angiography, doppler energy imaging, three-dimensional craniocerebral imaging and ultrasound thrombolysis are novel and valuable techniques in the study of cerebrovascular diseases. In this review, we introduce some of the new ultrasound techniques from both published studies and ongoing trials that have been confirmed to be convenient and effective methods. However, additional evidence from future studies will be required before some of these techniques can be widely applied or recommended as alternatives.

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Decreased Flow Velocity with Transcranial Color-Coded Duplex Sonography Correlates with Delayed Cerebral Ischemia due to Peripheral Vasospasm of the Middle Cerebral Artery

Cited by 8 publications

References 31 publications

Early recanalization and vasospasm after endovascular treatment in a case of ruptured vertebral artery dissecting aneurysm associated with COVID-19

Early recanalization and vasospasm after endovascular treatment in a case of ruptured vertebral artery dissecting aneurysm associated with COVID-19

Vasospasm following aneurysmal subarachnoid hemorrhage: prediction, detection, and intervention

Research progress in ultrasound use for the diagnosis and treatment of cerebrovascular diseases

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