Probabilityindex of Vasospasm using a combination of cerebral blood flow,clinical risks factors and the transcranial Doppler velocities tomake predictions on cerebral vasospasm hemorrhage.
Whatis the predictive accuracy in the use of spasm index, Lindegaardratio and TCD velocities in the diagnosis of vasospasm after ahemorrhage?
Whereto collect data set
Datawill be collected from patients in the Neurological Intensive CareUnit, patients with symptomatic Vasospasm, Neurosurgical centers andfrom treated patients.
Theplanned statistical approach
Thestudy will start by getting approval from hospital institution reviewboards and the Neurosurgical centers as well as approval consent frompatients with subarachnoid hemorrhage. Studies would be conducted onpatients who will be diagnosed with intracranial aneurysms those withlimited sonograpghic insight will be excluded. The diagnosis will bemade on the basis of admission to CT scans. In this study, patientsunder SAH trauma, artriovenous deformities and those of young agewill be excluded. Data would be collected for neurologicalexaminations, TCD and serial CT scans each morning. Baseline datawill be recorded for each patient on admission neurological statusduring admission, hospital complications, chest x-ray and others.
Clinicalcharacteristics will then be made on the recordings of Fisher grade,Hess and hunt grade after SAH, type of treatment, day of treatment,hypertension history or smoking history. Spasm indexes and Lindegaardratios will be calculated and digital subtraction angiographymeasured. In addition, predictive values, sensitivity and specificityvalues will be calculated. Later a regression analysis will be usedto assess the possible predictive factors, the coefficient ofregression logistics will be integrated to form the vasospasmprobability index (VPI)(Gonzalez, Boscardin, Glenn, Vinuela & Martin, 2007).
Gonzalez,Nestor R. M.D., W.John Boscardin, Ph.D., ThomasGlenn, Ph.D., FernandoVinuela, M.D. & NeilA. Martin, M.D. (2007).Vasospasm probability index: a combination of transcranial Dopplervelocities, cerebral blood flow, and clinical risk factors to predictcerebral vasospasm after aneurysmal subarachnoid hemorrhage. Vol. 107/ No. 6 / Pages 1101-1112. Retrieved on August 17, 2014, fromhttp://thejns.org/doi/abs/10.3171/jns-07/12/1101.