TY  - JOUR
A1  - Kunze, Ekkehard
A1  - Pham, Mirko
A1  - Raslan, Furat
A1  - Stetter, Christian
A1  - Lee, Jin-Yul
A1  - Solymosi, Laszlo
A1  - Ernestus, Ralf-Ingo
A1  - Hamilton Vince, Giles
A1  - Westermaier, Thomas
T1  - Value of Perfusion CT, Transcranial Doppler Sonography and Neurological Examination to detect delayed Vasospasm after aneurysmal Subarachnoid Hemorrhage [Research Article]
N2  - 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.
KW  - Medizin
Y1  - 2012
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/6576
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-76241
ER  -