J Clin Neurol.  2017 Jan;13(1):109-111. 10.3988/jcn.2017.13.1.109.

Real-Time Detection of Cerebral Artery Rebleeding by Transcranial Doppler Ultrasound: Hemodynamic Changes and Response to Treatment

• Marrotte E
• Mitsias P
• Melvin L
• Mahmood A
• Tsivgoulis G
• Varelas P

• KMID: 2364909
• DOI: http://doi.org/10.3988/jcn.2017.13.1.109

Abstract

No abstract available.

MeSH Terms

Cerebral Arteries*
Hemodynamics*
Ultrasonography*

Figure

• 

  Fig. 1 A: TCD waveforms before, during the bleed and post treatment (A and B left middle cerebral artery). Prior to bleed: ICP was 8 mm Hg, left MCA flow velocity was 61 cm/sec and PI was 1.0. During bleed: ICP increased to 54 mm Hg and PI to 1.7, with the waveform showing a narrow peak and decreased diastolic and mean velocity. 75 g of mannitol was given and the ventriculostomy was opened to drain. Within 5 minutes the ICP decreased to 14, PI improved to 1.4, the waveform widened and the velocities returned to previous levels. Please also see supplemental video. B: Telemetry data, mean arterial pressure increased and cerebral perfusion pressure increased before the rebleed. During rebleed there was a trend for ICP elevation (up to 54 mm Hg, but with poor waveform). After therapy with propofol and mannitol all normalized. ICP: intracranial pressure, MCA: middle cerebral artery, PI: pulsatility index, TCD: Transcranial Doppler ultrasound.

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