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Journal of Korean Neurosurgical Society > Volume 19(10-12); 1990 > Article
Journal of Korean Neurosurgical Society 1990;19(10-12): 1351-1360.
Transcranial Doppler Study in the Patients with Ruptured Cerebral Aneurysm: Preliminary Report.
Yong Soon Hwang, Jin Yang Joo, Seung Kon Huh, Kyu Chang Lee
1Department of Neurosurgery, Kosin Medical College, Pusan, Korea.
2Department of Neurosurgery, College of Medicine, Yonsei University, Seoul, Korea.
The authors performed prospectively the transcranial Doppler monitoring of bilateral anterior and middle cerebral arteries in 15 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who were admitted within 3 days after bleeding and had clinical grades of I, II, or III. The mean frequency shifts of bilateral anterior and middle cerebral arteries were increased immediately after ictus and showed continous further elevation between the 3rd and 8th rupture days. After that, they normalized slowly. The increase of frequency shift preceded clinical ischemic symptoms and an early steep increase of frequency shift was correlated to a high chance for suffering delayed ischemic deficits. The thick clots in subarachnoid cisterns shown on CT scans taken within the third rupture day were correlated well to the severe increase of frequency shifts. The aggressive treatment was done on asymptomatic patients who showed relatively rapid increase of frequency shifts, and they had shown no or trasient mild ischemic symptoms.
Key Words: Transcranial Doppler monitoring; Ruptured cerebral aneurysm; Frequency shift; Ischemic symptom; Clots on CT scan
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