Diagnostic value of patch-type ultrasound monitoring of internal carotid artery blood flow velocity in the acute stage of hypertensive cerebral hemorrhage

CHANG Hongbo; GAO Ming; XIE Shengqiang; YU Yaya; YIN Zhiyong; HAN Chengchen; WU Lin; SUN Junzhao; FANG Zhen; ZHANG Jianning

doi:10.3969/j.issn.1671-2897.2026.03.004

Abstract：Objective To explore the diagnostic value of continuous monitoring of dynamic changes in internal carotid artery blood flow velocity by patch ultrasound in the acute stage of hypertensive intracerebral hemorrhage(HICH).Methods A prospective study was conducted on twenty-nine randomly selected patients(18 males,11 females,with an average age of 65±13 years)with HICH admitted to the Department of Neurosurgery of the Sixth Medical Center of the PLA General Hospital from April 2024 to April 2025.Patch ultrasound was used to continuously monitor the internal carotid artery blood flow velocity of patients after cerebral hemorrhage,and the peak systolic velocity(Vs)and the end diastolic velocity(Vd),time-averaged velocity(Vm),pulsatility index(PI),and resistivity index(RI)were also measured.Patients with HICH were classified into gradesⅠto Ⅳ based on the amount of bleeding,and the internal carotid artery blood flow velocity indicators of different grades were compared.Meanwhile,a correlation analysis was conducted between the intracranial pressure(ICP)values and the internal carotid artery flow velocity indicators within 3 days after the operation in 8 patients with HICH.The internal carotid artery flow velocity indicators of the remaining 21 patients were recorded at 4 hours,24 hours,48 hours and 72 hours after cerebral hemorrhage respectively,and a correlation analysis was conducted on the volume of cerebral edema.The variation pattern of internal carotid artery velocity was analyzed in combination with the patient's condition,treatment outcome,etc.Results Among the 29 patients with HICH,16 underwent conservative treatment and the other 13 received surgery.According to the Karnofsky Performance Status(KPS)score of the patients'prognosis after treatment,they were categorized into 23 cases with a good prognosis and 6 cases with a poor prognosis(including 3 deaths),and the overall good prognosis rate was 79.31%.The differences in Vs,Vd,Vm,PI and RI among patients with different HICH grades were statistically significant(all P<0.05).Among them,Vs,Vd and Vm showed a decreasing trend with the increase of grades fromⅠto Ⅳ in HICH patients,while PI and RI showed an increasing trend.The ICP monitoring indicators within 3 days after surgery in 8 patients with HICH were negatively correlated with the internal carotid artery blood flow indicators Vs,Vd and Vm,and positively correlated with PI and RI(P<0.05).The internal carotid artery velocity indicators Vs,Vd and Vm within 3 days after cerebral hemorrhage in the remaining 21 patients decreased with the increase of cerebral edema volume,showing a negative correlation(P<0.05),while PI and RI increased,showing a positive correlation(P<0.05).Conclusions Patch-type ultrasound monitoring of internal carotid artery blood flow velocity can provide diagnostic basis for the amount of bleeding,changes in intracranial pressure,cerebral edema status,disease changes and treatment effectiveness of patients with HICH.