• Caroline Dietrich, Jasper van Lieshout, Igor Fischer, Marcel A Kamp, Jan F Cornelius, Angelo Tortora, Hans Jakob Steiger, and Athanasios K Petridis.
• Institute of Radiology, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany.
• Acta Neurochir. Suppl. 2020 Jan 1; 127: 155-160.

IntroductionThere is still controversial discussion of the value of transcranial Doppler (TCD) in predicting vasospasms in patients with aneurysmal SAH (aSAH). A newer method of predicting a delayed ischemic deficit (DCI) is CT perfusion (CTP), although it is not quite understood which kind of perfusion deficit is detected by this method since it seems to also identifying microcirculatory disturbances. We compared the TCD and CTP values with angiography and evaluated TCD and CTP changes before and after patients received intra-arterial spasmolytic therapy.Material And MethodsRetrospective analysis of TCD, CTP, and angiographies of N = 77 patients treated from 2013 to 2016. In 38 patients intra-arterial spasmolysis had been performed, and in these cases TCD and CTP data were compared before and after lysis. Thirty-nine patients had a pathological CTP but no angiographically seen vasospasm.ResultsThere was no correlation between the known thresholds of mean transit time (MTT) in CTP and vasospasm or with mean velocities in TCD and vasospasm. After spasmolysis in patients with vasospasms, only the MTT showed significant improvement, whereas TCD velocities and Lindegaard index remained unaffected.ConclusionTCD and CTP seem to identify different pathological entities of DCI and should be used supplementary in order to identify as many patients as possible with vasospasms after aSAH.

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