Correlation between transcranial doppler findings, neuroimaging and functional status in the first days of acute intracerebral hemorrhage

Abstract

Objectives: To have an appropriate and accessible modality for monitoring of patients with intracerebral hemorrhage (ICH) that have a correlation with Computed tomography (CT) scan data, we conducted a study to compare Transcranial Doppler finding with CT data in the first and 5th day after ICH and clear their relations with functional status (FS) of patients. Methodology: We prospectively studied 50 patients with supratentorial ICH evaluated in less than 24 hours of its onset. All selected patients underwent emergent CT scan and TCD on admission. Doppler parameters of middle cerebral arteries [including systolic, diastolic and mean velocities, Pulsatility index (PI), Diastolic flow velocity (DFV)] were recorded in first and fifth days of admission by TCD. FS of patients was measured using National Institutes of Health Stroke Scale (NIHSS) score in these days. Results: Twenty six female patients and 24 male entered the study with NIHSS score average of 14 +/- 6.5 in first and 13.7 +/- 7.3 in 5th days. Their hematoma volume was 13.5 +/- 1.7 millimeter in average. There was a significant reverse relation between DFV of 1st day and NIHSS score in unaffected hemisphere in first and 5th days (First day: P=0.03 & 5th day: P<0.001). Also there was a positive relation between PI and NIHSS score in unaffected hemisphere in 5th day (P=0.03). PI had no difference in the patients with intraventricular hemorrhage (IVH) and patients without the IVH, even though PI cannot predict the site of hematoma but DFV in 5th day, in unaffected hemisphere can be a predictive factor for intraventricular hemorrhage. Conclusion: Most of TCD parameters were correlated with functional status and some of them (DFV, PI) had prediction value for intraventricular hemorrhage in acute phase of ICH. Also they had a high correlation with CT scan findings.