gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Arteriovenous differences and transcranial doppler sonography in the monitoring of cerebral vasospasm after aneurysmal subarachnoid hemorrhage

Arteriovenöse Differenzen und transkranielle Dopplersonographie beim Monitoring des zerebralen Vasospasmus nach aneurysmatischer Subarachnoidalblutung

Meeting Abstract

  • corresponding author M. Oertel - Neurochirurgische Klinik, Universitätsklinikum Gießen
  • G. Dabelow - Neurochirurgische Klinik, Universitätsklinikum Gießen
  • M. Krause - Neurochirurgische Klinik, Universitätsklinikum Gießen
  • W. Scharbrodt - Neurochirurgische Klinik, Universitätsklinikum Gießen
  • D.-K. Böker - Neurochirurgische Klinik, Universitätsklinikum Gießen
  • W. Deinsberger - Neurochirurgische Klinik, Universitätsklinikum Gießen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-13.02

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Oertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




After subarachnoid hemorrhage (SAH) the detection of hemodynamically significant vasospasm is frequently difficult especially in comatose patients. Most clinicians use transcranial Doppler sonography (TCD) to detect increasing mean blood flow velocities of the basal arteries as marker of cerebral vasospasm without accounting for the effects of sedation and variations in blood pressure or PaCO2. This study was conducted to test the hypothesis that the arteriovenos difference for oxygen (avDO2) is equally usefull for the evaluation of vasospasm than TCD.


A total of 15 SAH patients (m:f = 1:1.1, age 54.5±12.2 years, median Hunt & Hess 4) were prospectively enrolled. All patients were sedated with standardized continuous doses of midazolam and fentanyl. TCD studies and avDO2 were conducted at the same time or in close proximity. The blood flow velocity of the middle cerebral artery was recorded. A cranial CT was conducted if the avDO2 increased by at least 0.8 Vol%.


Overall 54 measurements were recorded in 15 patients between Day 1 and 13 after SAH. Between Day 3 and 10 a total of 16 studies showed a mean increase in avDO2 by 1.23±1 vol% while TCD velocities remained either unchanged, increased or decreased. In all cases where CT studies were prompted vasospasm related hypodensities were seen.


TCD velocities alone are a poor parameter to follow the severity of vasospasm. In contrast, the daily avDO2 seemed to be more robust for the monitoring. However, additional metabolic information is warranted.