{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:17:43Z","timestamp":1773047863657,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>\n                      While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (\u0394\n                      <jats:italic>P<\/jats:italic>\n                      ) can be estimated using PI, we investigated the potential significance of TCD\u2010estimated \u0394\n                      <jats:italic>P<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures. Using a previously reported mathematical model, we estimated \u0394\n                      <jats:italic>P<\/jats:italic>\n                      by dividing pulse pressure by PI. We investigated the association between \u0394\n                      <jats:italic>P<\/jats:italic>\n                      and mCBFV values and two acute phase complications of SAH\u2014DCI and angiographic vasospasm. Additionally, we explored the association between DCI, vasospasm, and 90\u2010day functional outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Elevated \u0394\n                      <jats:italic>P<\/jats:italic>\n                      was associated with DCI (odds ratio [OR] 1.021, 95% confidence interval [CI] 1.004\u20131.039,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.014) but not vasospasm (OR 1.006, 95% CI 0.991\u20131.022,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.402). Elevated mCBFV was associated with vasospasm (OR 1.037, 95% CI 1.017\u20131.057,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) but not DCI (OR 0.998, 95% CI 0.979\u20131.018,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.873). DCI (OR 29.380, 95% CI 2.930\u2013294.615,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004), rather than vasospasm (OR 0.695, 95% CI 0.120\u20134.043,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.686), was associated with functional outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Increased \u0394\n                      <jats:italic>P<\/jats:italic>\n                      , rather than elevated mCBFV, was associated with DCI. While elevated mCBFV was associated with vasospasm, it was not associated with DCI. Hence, TCD\u2010estimated \u0394\n                      <jats:italic>P<\/jats:italic>\n                      may serve as a predictor for the DCI in SAH patients, a condition that impacts long\u2010term outcome.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70010","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T06:21:45Z","timestamp":1736749305000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Transcranial Doppler Arterial Pressure Gradient Is Associated With Delayed Infarction After Subarachnoid Hemorrhage"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6389-7423","authenticated-orcid":false,"given":"Yongwoo","family":"Kim","sequence":"first","affiliation":[{"name":"Comrehensive Stroke Center MedStar Washington Hospital Center Washington District of Columbia USA"},{"name":"Department of Neurology Georgetown University School of Medicine Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Kim","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef D.","family":"Williams","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Withington","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eshetu","family":"Tefera","sequence":"additional","affiliation":[{"name":"Center for Biostatistics Informatics and Data Science MedStar Health Research Institute Hyattsville Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samrawit","family":"Gizaw","sequence":"additional","affiliation":[{"name":"Center for Biostatistics Informatics and Data Science MedStar Health Research Institute Hyattsville Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Felbaum","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey C.","family":"Mai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai\u2010Hsi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocco A.","family":"Armonda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason J.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology Georgetown University School of Medicine Washington District of Columbia USA"},{"name":"Department of Critical Care Medicine MedStar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"e314","article-title":"2023 guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association\/American Stroke Association","volume":"54","author":"Hoh B. L.","year":"2023","journal-title":"Stroke; A Journal of Cerebral Circulation"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12975\u2010024\u201001290\u20105"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2006.00083.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/00359157740676P113"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1991.01030175.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.116934"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.13132"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2006.00088.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_192_17"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01405268"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003297"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.589275"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2023.120691"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-008-0466-7"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199906000-00039"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011403"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017777"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.597005"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.106.477976"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000349209.69973.88"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.JNS15428"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7347"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-018-0572-2"}],"container-title":["Journal of Neuroimaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.70010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jon.70010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.70010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T08:21:41Z","timestamp":1773044501000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jon.70010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/jon.70010"],"URL":"https:\/\/doi.org\/10.1111\/jon.70010","archive":["Portico"],"relation":{},"ISSN":["1051-2284","1552-6569"],"issn-type":[{"value":"1051-2284","type":"print"},{"value":"1552-6569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70010"}}