caa a22 4500 477106862 CHVBK 20180405111556.0 cr unu---uuuuu 170330e19960901xx s 000 0 eng 10.1007/BF01412310 doi (NATIONALLICENCE)springer-10.1007/BF01412310 A new, more dependable methodology for the use of transcranial Doppler ultrasonography in the management of subarachnoid haemorrhage [Elektronische Daten] [T. Kiliç, M. Pamir, M. Özek, T. Zirh, C. Erzen] Summary: The role of transcranial Doppler ultrasound (TCD) in clinical decision making about vasospasm due to subarachnoid haemorrhage (SAH), shows a great variation according to neurosurgical clinics. In this prospective study, a total of 143 patients, admitted to Marmara University Department of Neurosurgery between January 1991 to March 1995 and treated surgically with the diagnosis of aneurysmal SAH, were examined by TCD. Eighty of these patients fulfilled the requirements for inclusion. In order to increase clinical dependability of TCD, a new grading system is proposed and tested in comparison with the one previously used, which takes absolute flow velocities as the main parameter in grading. The new, individually based TCD grading system is proposed to minimize the pitfalls caused by proximal stenosis, wide range of normal Vm values and proximally evolving vasospasm. We concluded that: 1) The new, individually based TCD grading system has a high degree of clinical dependability. 2) Daily TCD examinations supply reliable predictive information about developing delayed ischaemic deficit (DID). If a TCD Gr II patient shows an increase of 35cm/sec (in 24 hours) in Vm value, his probability of developing DID was found to be 60% (p<0.05); if a TCD Gr B III patient shows the same rate of increase in Vm, his probability of developing DID was 80% (<0.05). 3) TCD has an important clinical role in decision making about the management of SAH patients. 4) Surgical manipulation causes a reversible increase of one or two TCD-grades in the early postoperative days. Springer-Verlag, 1996 Blood flow velocity nationallicence cerebral aneurysm nationallicence delayed ischaemic deficit nationallicence transcranial Doppler sonography nationallicence vasospasm nationallicence Kiliç T. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut Pamir M. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut Özek M. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut Zirh T. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut Erzen C. Department of Radiology, Marmara University Hospital, Istanbul, Turkey aut Acta Neurochirurgica Springer-Verlag 138/9(1996-09-01), 1070-1078 0001-6268 138:9<1070 1996 138 701 https://doi.org/10.1007/BF01412310 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01412310 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kiliç T. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Pamir M. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Özek M. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Zirh T. Department of Neurosurgery, Marmara University Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Erzen C. Department of Radiology, Marmara University Hospital, Istanbul, Turkey aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/9(1996-09-01), 1070-1078 0001-6268 138:9<1070 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer