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Predictive value of cerebrovascular time constant for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Published version
Peer-reviewed

Repository DOI


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Authors

Uryga, Agnieszka 
Kasprowicz, Magdalena 
Budohoski, Karol 
Nasr, Nathalie 
Czosnyka, Marek 

Abstract

Time constant of the cerebral arterial bed (τ) is a transcranial Doppler (TCD) based metric that is expected to quantify the transit time of red blood cells from the insonation point to the arteriole-capillary boundary during a cardiac cycle. This study aims to assess the potential of τ as an early predictor of delayed cerebral ischemia (DCI). Consecutive patients (56 ± 15 years) treated for aneurysmal subarachnoid haemorrhage were included in the study. τ was assessed through a modelling approach that involved simultaneous recordings of arterial blood pressure and cerebral blood flow velocity (CBFV) from TCD's first recordings. 71 patients were included. 17 patients experienced DCI. τ was significantly shorter in patients who later developed DCI: 187 ± 64 ms vs. 249 ± 184 ms; p = 0.040 with moderate effect size (rG = 0.24). Logistic regression showed that there was a significant association between increased CBFV, shortened τ, and the development of DCI (χ2 = 11.54; p = 0.003) with AUC for the model 0.75. Patients who had both shortened τ and increased CBFV were 20 times more likely to develop DCI (OR = 20.4 (2.2-187.7)). Our results suggest that early alterations in τ are associated with DCI after aSAH. The highest performance of the model including both CBFV and τ may suggest the importance of both macrovascular and microvascular changes assessment.

Description

Peer reviewed: True

Keywords

Cerebrovascular regulation, cerebral blood flow velocity, delayed ischemic deficit, subarachnoid haemorrhage, transcranial Doppler, Humans, Subarachnoid Hemorrhage, Middle Aged, Male, Cerebrovascular Circulation, Female, Brain Ischemia, Ultrasonography, Doppler, Transcranial, Aged, Blood Flow Velocity, Adult, Predictive Value of Tests

Journal Title

J Cereb Blood Flow Metab

Conference Name

Journal ISSN

0271-678X
1559-7016

Volume Title

44

Publisher

SAGE Publications