Annals of Indian Academy of Neurology
  Users Online: 33 Home | About the Journal | InstructionsCurrent Issue | Back IssuesLogin      Print this page Email this page  Small font size Default font size Increase font size
 
ORIGINAL ARTICLE
Ahead of Print

Transcranial Doppler and hematoma expansion in acute spontaneous primary intracerebral hemorrhage


1 Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Neuroradiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Radiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dheeraj Khurana,
Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Context: The data on the role of Transcranial Doppler (TCD) in the management of acute primary intracerebral hemorrhage (ICH) is meager. Aims: To study TCD variables associated with hematoma expansion in acute primary ICH. Settings and Design: The study was carried out in the neurosciences department of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh from July 2010 to September 2011 employing a prospective, double blinded non randomized study design. Materials and Methods: Acute ICH patients within 24 h of symptom onset were recruited. Baseline neuroimaging study (Computerized tomography, CT scan of brain) was performed to assess the pure hematoma volume by AXBXC/2 method. Baseline TCD parameters were obtained from both the middle cerebral arteries (MCAs; affected and unaffected hemisphere): Peak Systolic velocity, End Diastolic velocity, Mean Flow velocity, Resistance Index, and Pulsatility Index. Follow up (24 h) assessment of hematoma volume and TCD were carried out. Each of the TCD variables were compared in hematoma expansion (>33% increase in hematoma volume on the follow-up CT) and non-expansion group. Statistical analysis: On univariate analysis, the Student's t-test and contingency tables with the X 2 test were used. A forward stepwise multivariate logistic regression analysis with hematoma expansion at 24 h as the dependent variable and ROC analysis was carried out, using SPSS software version 16 (Chicago, IL). P value < 0.05 was considered significant. Results: Twenty-five patients completed the study. Ten patients (40%) had hematoma expansion. Multivariate analysis revealed unaffected hemisphere MCA Pulsatility Index ratio [unaffected hemisphere MCA Follow up Pulsatility Index/baseline Pulsatility Index] of > 1.055 as the lone correlate of hematoma expansion (sensitivity of 90% and specificity of 60%). Conclusion: Frequent assessment with TCD could aid in prediction of hematoma expansion by measuring unaffected hemisphere Pulsatility Index ratios.


Print this article
 [NEXT]
 [PREV]
 Table of Contents

  Search Pubmed for
 
    -  Kesav P
    -  Khurana D
    -  Prabhakar SK
    -  Ahuja CK
    -  Khandelwal N
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed925    
    PDF Downloaded35    

Recommend this journal