Cranial Accelerometry Can Detect Cerebral Vasospasm Caused by Subarachnoid Hemorrhage.
Background: We previously reported the presence of a cranial "bruit" in patients with cerebral vasospasm by signal processing cranial accelerometry signals time locked to the cardiac cycle. This shift to higher frequencies is likely related to the turbulence of blood flow produced by vascular narrow...
| Publicado en: | Neurocritical Care Vol. 23; no. 3; pp. 364 - 370 |
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| Autores principales: | , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110726535&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110726535 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15416933 1WYA jtl: Neurocritical Care issn: 15416933 maglogo: N pubinfo: dt: Dec2015 vid: 23 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 110726535 110726535 NLM25761424 110726535 10.1007/s12028-015-0118-9 NLM25761424 110726535 ppf: 364 ppct: 6 formats: tig: atl: Cranial Accelerometry Can Detect Cerebral Vasospasm Caused by Subarachnoid Hemorrhage. aug: au: Smith, Wade Browne, Janet Ko, Nerissa Smith, Wade S Browne, Janet L Ko, Nerissa U affil: Department of Neurology, University of California, San Francisco, San Francisco USA sug: subj: Ultrasonography, Doppler, Transcranial Methods Models, Biological Cerebral Vasospasm Diagnosis Accelerometry Methods Subarachnoid Hemorrhage Diagnosis Reproducibility of Results Subarachnoid Hemorrhage Ultrasonography Algorithms Cerebral Vasospasm Ultrasonography Prospective Studies Sensitivity and Specificity Single-Blind Studies Human ab: Background: We previously reported the presence of a cranial "bruit" in patients with cerebral vasospasm by signal processing cranial accelerometry signals time locked to the cardiac cycle. This shift to higher frequencies is likely related to the turbulence of blood flow produced by vascular narrowing. We sought to build a more quantitative model to predict cerebral vasospasm then test the accuracy of this technique to detect cerebral vasospasm in a prospective blinded study.Methods: Skull accelerometry was performed using an array of 6 highly sensitive accelerometers placed in contact with the scalp. Paired transcranial Doppler (TCD) recordings and accelerometry epochs were obtained in consecutive patients with subarachnoid hemorrhage undergoing TCD recordings for surveillance of cerebral vasospasm. The energy of rectified acceleration measurements within systolic and diastolic bands of the cardiac cycle were measured and correlated with TCD-defined spasm. This model was then tested prospectively in a blinded consecutive sample of subarachnoid hemorrhage patients to determine accuracy of the technique.Results: We developed a model predicting cerebral vasospasm from analysis of 14 unblinded subjects with varying degrees of cerebral vasospasm as detected by TCD. We then recorded from 58 subjects obtaining 125-paired recordings of accelerometry and TCD to test this model in a blinded analysis. Accelerometry detection of any spasm versus non-spasm correlated with TCD-defined vasospasm (P < 0.001). The model was 81 % sensitive for detecting any cerebral vasospasm in patients, while the negative predictive value was 61 %.Conclusion: Highly sensitive skull accelerometry can detect cerebral vasospasm with clinically meaningful accuracy. This tool holds promise in the ICU environment to detect as well as reject cerebral vasospasm as the cause of neurological deficits in subarachnoid hemorrhage. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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