J Cerebrovasc Endovasc Neurosurg.  2021 Dec;23(4):334-342. 10.7461/jcen.2021.E2021.05.001.

Transcranial Doppler study in acute spontaneous intracerebral hemorrhage: The role of pulsatility index

• Park J
• Hwang SK

• KMID: 2523891
• DOI: http://doi.org/10.7461/jcen.2021.E2021.05.001

Abstract

Objective
Pulsatility index (PI) is a parameter calculated by transcranial Doppler sonography (TCD), which is commonly used for patients with subarachnoid hemorrhage or ischemic stroke. However, we performed a retrospective analysis of patients with acute spontaneous intracerebral hemorrhage (ICH) to assess the function of TCD, particularly the PI.
Methods
This study involved a total of 46 patients with acute ICH who received treatment at a single center between May 2013 and December 2014. Medical records of baseline characteristics, except for the modified Rankin scale, were obtained at initial evaluation in the emergency room, and TCD was used to calculate middle cerebral artery flow velocity (MFV) and PI at admission (baseline), 24 h, and 7 days. The PI and MFV values on the affected middle cerebral artery were compared with those on the contralateral side. Linear regression analysis was used for statistical analyses (SPSS 21.0, IBM Corp., Armonk, NY, USA).
Results
Statistical analysis indicated that sex, age, Glasgow coma scale, intraventricular hemorrhage, and hematoma size were not correlated with PI (p＞0.05); however, only PI was positively correlated with functional outcome at 6 months after treatment (R=0.846, p=0.002).
Conclusions
These results provide evidence that the parameter of PI is an independent determinant prognostic factor in acute spontaneous ICH. Further research is needed to investigate the influence of cerebral blood flow dynamics on a larger, more controlled, and more randomized basis.

Keyword

Functional outcome; Intracerebral hemorrhage; Pulsatility index; Transcranial Doppler sonography

Figure

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  Fig. 1. Location of ICH. (A) Basal ganglia hemorrhage. (B) Thalamic hemorrhage. (C) Lobar hemorrhage. ICH, intracerebral hemorrhage.

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  Fig. 2. TCD probe is placed on temporal region of head, insonating MCA. TCD, transcranial Doppler sonography; MCA, middle cerebral artery.

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  Fig. 3. Parameter values acquired from patient without brain lesion by TCD, shown on monitor (BMS-9UA & TERASON 3000 COMBI). TCD, transcranial Doppler sonography.

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