Predictive Value of Mean Flow Velocity by TCD in Early Cerebral Vasospasm in Aneurysmal Subarachnoid Hemorrhage

NCT04329208 | Completed

• 1 other identifier: Mansoura University 14
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Aim of this work is to evaluate the transcranial doppler in prediction of cerebral vasospasm in aneurysmal subarachnoid hemorrhage and also to evaluate their advantages over clinical scales in predicting CV.

Conditions

Subarachnoid Hemorrhage

Outcome Measures

Primary Outcomes (1)

• Mean Flow Velocity

  TCD utilizes low-frequency pulsed insonation (2 MHz) to measure blood flow velocity within proximal cerebral arteries, obtaining systolic and diastolic peaks and mean flow velocities (MFV). MFV is defined as (systolic + diastolic)/3 + diastolic velocities.

  10 days

Study Arms (2)

Cerebral vasospasm

13 patients developed symptomatic cerebral vasospasm detected by CT angiography and TCD

Device: Transcranial doppler

Non Vasospasm

27 patients without cerebral vasospasm

Device: Transcranial doppler

Interventions

Transcranial doppler DEVICE

TCD examination was performed using DWL-EZ-Dop machine Compumedics GmbH, Singen, Germany. TCD utilizes low-frequency pulsed insonation (2 MHz) to measure blood flow velocity within proximal cerebral arteries, obtaining systolic and diastolic peaks and mean flow velocities (MFV). MFV is defined as (systolic + diastolic)/3 + diastolic velocities, according to Alexandrov et al.. Initial TCD examination was done after admission serving as a baseline state for cerebral circulation. Follow-up TCD examinations was done at fixed intervals on the first, third, fifth, seventh and tenth days of the onset of SAH.

Cerebral vasospasm; Non Vasospasm

Eligibility Criteria

• Age: 30 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

This study was a prospective study conducted on 45 consecutive aSAH patients Forty patients continued in the study and five patients were excluded because of their clinical deterioration within the first five days of the onset and or the associated decompensated systemic illness. SAH cases divided according to the presence of vasospasm into two groups; the first group included 27 cases without vasospasm, while the second group included 13 cases with vasospasm.

You may qualify if:

• Adult patients diagnosed with spontaneous aneurysmal SAH diagnosed by non-contrast brain CT scan at the onset and confirmed by CT angiography within 72 hours of onset were included

You may not qualify if:

• Patient with previous history of disabling brain injuries causing focal neurological signs (e.g. motor weakness).
• Patients with poor temporal TCD window required for bedside evaluation of CV.
• Patients with decompensated systemic illness like hepatic, renal and cardiac were excluded.
• Patients with deep coma (GCS\<6) were excluded.

Sponsors & Collaborators

• Mansoura University Hospital: lead

Study Sites (1)

Mansoura University Hospital

Al Mansurah, Egypt

Location

Related Publications (1)

• Esmael A, Belal T, Eltoukhy K. Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers. Stroke Res Treat. 2020 Nov 23;2020:8874605. doi: 10.1155/2020/8874605. eCollection 2020.

  PMID: 33299539 DERIVED

MeSH Terms

Conditions

Subarachnoid Hemorrhage

Interventions

Ultrasonography, Doppler, Transcranial

Condition Hierarchy (Ancestors)

Intracranial Hemorrhages; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Hemorrhage; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Echoencephalography; Neuroradiography; Neuroimaging; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis; Radiography; Ultrasonography; Ultrasonography, Doppler; Diagnostic Techniques, Neurological; Investigative Techniques

Study Officials

• Esmael M Ahmed, MD

  Assistant Prof of Neurology

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Prof of Neurology

Study Record Dates

• First Submitted: March 30, 2020
• First Posted: April 1, 2020
• Study Start: January 1, 2018
• Primary Completion: January 1, 2019
• Study Completion: February 1, 2019
• Last Updated: April 1, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)