Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers
Joint Authors
Esmael, Ahmed
Belal, Tamer
Eltoukhy, Khaled
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-11, 11 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-11-23
Country of Publication
Egypt
No. of Pages
11
Main Subjects
Abstract EN
Background and Aim.
Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) stays under investigation.
This study is aimed at predicting the cognitive impairment by transcranial Doppler (TCD) and detecting the associated clinical biomarkers of impaired cognition after aSAH after 3 months from the onset.
Methods.
Prospective study included 40 cases with acute aSAH.
Initial evaluation by Glasgow Coma Scale (GCS) and the severity of aSAH was detected by both the clinical Hunt and Hess and radiological Fisher’s grading scales.
TCD was done for all patients five times within 10 days measuring the mean flow velocities (MFVs) of cerebral arteries.
At the 3-month follow-up, patients were classified into two groups according to Montreal Cognitive Assessment (MoCA) scale: the first group was 31 cases (77.5%) with intact cognitive functions and the other group was 9 cases (22.5%) with impaired cognition.
Results.
Patients with impaired cognitive functions showed significantly lower mean GCS (p=0.03), significantly higher mean Hunt and Hess scale grades (p=0.04), significantly higher mean diabetes mellitus (DM) (p=0.03), significantly higher mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) (p=0.02 and p=0.005, respectively), and significantly higher MFVs measured within the first 10 days.
The patients with cognitive impairment were accompanied by a higher incidence of hydrocephalus (p=0.01) and a higher incidence of delayed cerebral ischemia (DCI) (p<0.001).
Logistic regression analysis detected that MFV≥86 cm/s in the middle cerebral artery (MCA), MFV≥68 cm/s in the anterior cerebral artery (ACA), and MFV≥45 cm/s in the posterior cerebral artery (PCA) were significantly associated with increased risk of cognitive impairment.
Conclusion.
Cognitive impairment after the 3-month follow-up phase in aSAH patients was 22.5%.
Acute hydrocephalus and DCI are highly associated with poor cognitive function in aSAH.
Increased MFV is a strong predictor for poor cognitive function in aSAH.
This trial is registered with NCT04329208.
American Psychological Association (APA)
Esmael, Ahmed& Belal, Tamer& Eltoukhy, Khaled. 2020. Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers. Stroke Research and Treatment،Vol. 2020, no. 2020, pp.1-11.
https://search.emarefa.net/detail/BIM-1209410
Modern Language Association (MLA)
Esmael, Ahmed…[et al.]. Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers. Stroke Research and Treatment No. 2020 (2020), pp.1-11.
https://search.emarefa.net/detail/BIM-1209410
American Medical Association (AMA)
Esmael, Ahmed& Belal, Tamer& Eltoukhy, Khaled. Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers. Stroke Research and Treatment. 2020. Vol. 2020, no. 2020, pp.1-11.
https://search.emarefa.net/detail/BIM-1209410
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1209410