Clinical Application of Bedside Transcranial Color Coded Duplex Sonography in Monitoring Subarachnoid Hemorrhage Cerebral Vasospasm

ZHOU Jianyong; HUANG YUjing; Ling Shuang; ZENG Fanmeng; MAI Yuchan; ZHAO Tianyi; YU Haobin; SU Wenqin

doi:10.14033/j.cnki.cfmr.2025.18.020

Abstract：Objective:To explore the application value of bedside Transcranial Color Coded Duplex(TCCD)Sonography in monitoring cerebral vasospasm(CVS)after subarachnoid hemorrhage(SAH).Method:40 patients with SAH after aneurysm rupture(study group)and 40 patients with simple SAH(control group)admitted to Zhaoqing First People's Hospital of Guangdong Province from September 2023 to March 2025 were selected as the study objects.All patients received digital subtraction angiography(DSA)and bedside TCCD examination.Two groups of TCCD parameters were compared,and the diagnostic results of DSA were used as the gold standard to analyze the diagnostic efficacy of TCCD for CVS after SAH.The modified Fisher scale and Hunt-Hess scale were used to evaluate the patients'condition,and the correlation between TCCD parameters and the modified Fisher scale and Hunt-Hess scale was analyzed.Result:On 1 d,4 d,7 d and 14 d after admission,the peak systolic flow velocity and mean flow velocity(MV)of middle cerebral artery(MCA)in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).Among the 80 patients included in the study,37 patients with CVS after SAH were found by TCCD examination.Compared with the results of DSA,it was found that the sensitivity,specificity and accuracy of CVS diagnosis by TCCD were 85.00%,92.50%and 88.75%.Pearson correlation analysis showed that MV value of MCA was positively correlated with the modified Fisher grade and Hunt-Hess grade,and the difference was statistically significant(r=0.624,0.516,P<0.05).Conclusion:The MCA blood flow parameters of patients with SAH can be easily obtained by bedside TCCD examination.The MCA blood flow velocity of patients with CVS is faster than that of those without CVS.The TCCD related parameters have good diagnostic efficacy for CVS after SAH,and the MV value of MCA is positively correlated with the risk of CVS occurrence and the severity of patients'disease.It is necessary to improve the bedside TCCD examination of SAH patients as soon as possible,continuously monitor the MCA blood flow parameters,and reasonably predict the risk of CVS.