HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Martí–Fàbregas, J. Articles by Martí–Vilalta, J.-L. Search for Related Content PubMed PubMed Citation Articles by Martí–Fàbregas, J. Articles by Martí–Vilalta, J.-L. Related Collections Ultrasound Critical care Intracerebral hemorrhage Coma

Prognostic value of Pulsatility Index in acute intracerebral hemorrhage

From the Departments of Neurology (Drs. Martí–Fàbregas, Belvís, Cocho, and Martí–Vilalta), Internal Medicine (Dr. Muñoz), and Intensive Care (Dr. Marruecos) and Neuroradiological Section (Dr. Guardia), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.

Address correspondence and reprint requests to Dr. J. Martí–Fàbregas, Servei de Neurologia, Hospital de la Santa Creu i Sant Pau, Avda. Sant Antoni M. Claret, 167, 08025 Barcelona, Spain; e-mail: jmarti{at}hsp.santpau.es

Objective: To investigate whether data obtained by transcranial Doppler (TCD) have prognostic value in patients with intracerebral hemorrhage (ICH).

Methods: A prospective study of patients with an acute (<12 hours from onset of symptoms) spontaneous supratentorial ICH was conducted. Mortality was assessed at 30-day follow-up. TCD parameters were obtained from both middle cerebral arteries: systolic, diastolic, and mean velocities and Pulsatility Index (PI) from the affected and unaffected hemispheres. The following variables were included in a univariate analysis: age, sex, hematoma volume, hypodense volume around the hematoma, total volume, midline shift, ventricular size, Glasgow Coma Scale score, intraventricular hemorrhage, body temperature, white cell count, blood glucose, mean blood pressure, and TCD data. A multivariate analysis was performed with variables that showed significance in the univariate analysis. Receiver-operator characteristic (ROC) curves were obtained.

Results: Forty-eight patients (age 66.5 ± 12.5 years; 28 men) were studied. Mortality at 30 days was 31%. The only predictor of mortality was the Glasgow Coma Scale score (odds ratio [OR] 0.67, CI 0.53 to 0.84, p = 0.001), whereas the PI from the unaffected hemisphere was correlated with mortality (OR 2.3, CI 0.92 to 5.72, p = 0.07). The area under the ROC curve was 0.92. A cutoff for PI from the unaffected hemisphere of 1.75 showed a specificity of 94% and a sensitivity of 80% as a predictor of death at 30 days.

Conclusions: The PI of the unaffected hemisphere may be a predictor of death in acute ICH. These findings suggest that intracranial hypertension is the most likely cause of death in most patients with ICH.

Received February 9, 2003. Accepted in final form June 10, 2003.

This article has been cited by other articles:

				J. Broderick, S. Connolly, E. Feldmann, D. Hanley, C. Kase, D. Krieger, M. Mayberg, L. Morgenstern, C. S. Ogilvy, P. Vespa, et al. REPRINT: Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, October 16, 2007; 116(16): e391 - e413. [Abstract] [Full Text] [PDF]

				J. Broderick, S. Connolly, E. Feldmann, D. Hanley, C. Kase, D. Krieger, M. Mayberg, L. Morgenstern, C. S. Ogilvy, P. Vespa, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke, June 1, 2007; 38(6): 2001 - 2023. [Abstract] [Full Text] [PDF]

				A. Hays and M. N. Diringer Elevated troponin levels are associated with higher mortality following intracerebral hemorrhage Neurology, May 9, 2006; 66(9): 1330 - 1334. [Abstract] [Full Text] [PDF]

				S.-C. Tang, S.-J. Huang, J.-S. Jeng, and P.-K. Yip Third Ventricle Midline Shift Due to Spontaneous Supratentorial Intracerebral Hemorrhage Evaluated by Transcranial Color-Coded Sonography J. Ultrasound Med., February 1, 2006; 25(2): 203 - 209. [Abstract] [Full Text] [PDF]

				J. Marti-Fabregas, R. Belvis, E. Guardia, D. Cocho, and J.-L. Marti-Vilalta Relationship between Transcranial Doppler and CT Data in Acute Intracerebral Hemorrhage AJNR Am. J. Neuroradiol., January 1, 2005; 26(1): 113 - 118. [Abstract] [Full Text] [PDF]

				Pulsatility Index May Predict Poor Outcome After Intracerebral Hemorrhage Journal Watch Neurology, January 16, 2004; 2004(116): 6 - 6. [Full Text]