NEUROIMAGING / NEUROSONOLOGY

TCD/TCCD vasospasm monitoring

Created 31/03/2021, last revision 16/09/2022

  • vasospasm is a contraction of the muscular wall of an artery, leading to its stenosis and reduced flow
  • the prevalence of vasospasms following SAH is between 50-70%
  • vasospasms in SAH patients occur around the 3rd to 5th day and last up to 3-4 weeks
  • approximately 30% of aneurysmal SAH patients develop delayed ischemic deficit (DID) (Yamaki, 2019)

    • DID is the leading preventable cause of poor outcome in aneurysmal SAH patients
  • increased risk of spasms is associated with:
  • the risk of complications increases with the number of affected arteries and with hemodynamically significant spasms

Vasospasms Detection and Monitoring

  • neurosonology (TCCD/TCD)
  • CT angiography
    • CT perfusion imaging (CTP) can aid in the prediction of DID
  • MR angiography
    • low sensitivity for diagnosing distal ICA vasospasms
    • MR perfusion may aid in the prediction of DID
  • digital subtraction angiography (DSA)
    • if local endovascular treatment is indicated

TCCD Criteria

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