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Follow-up of Vasospasm by Transcranial Doppler Sonography (TCD) in Subarachnoid Hemorrhage (SAH)

Jasminka Djelilovic-Vranic, Vanja Basic-Kes, Merita Tiric-Campara, Edina Djozic, Jasmin Kulenovic.

Introduction: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics. Goal: The goal is to follow the occurrence of vasospasm after SAH, by the TCD method. Material and methods: We have analyzed 47 patients with SAH, by analyzing the presence of aneurysm, hypertension and smoking, and by the TCD method monitor the state of intracerebral hemodynamics during the first four days, then in the second and third week. Results: SAH was more common in women (61.7%) than men (38.3%), and in the age range from 22 to 64 years. Aneurism was demonstrated in 61.7% of patients, more common in women, with hypertension 68.1% also more common in women and smoking in 87.2% of patients, also more common in women. By TCD method are recorded milder, elevated blood flow velocities at a quarter of patients in the first measurement, during the second measurement at all and it had significantly greater value, and the third measurement also more increased in about a quarter of patients, so that there is a statistically significant difference in the first and second, second and third measurement for each vessel separately, but not between the first and third measurement. Conclusion: Predilection factors for SAH are aneurysms, hypertension and smoking. By using TCD method were recorded milder elevated blood flow velocity in the first days of SAH, with about a quarter of patients, significantly greater increase in blood flow velocity during the second week in all patients and also milder increase blood flow velocity in the third week of the start of SAH is a quarter of patients. TCD is the method of choice in the evaluation and management of vasospasm after SAH, which allows the prevention of delayed cerebral ischemia.

Key words: SAH, vasospasm, TCD.

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