{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T17:24:46Z","timestamp":1758043486223,"version":"3.44.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Transcranial Doppler (TCD) is widely used to predict cerebral vasospasm in patients with subarachnoid hemorrhage by monitoring mean flow velocity (MFV) in major cerebral arteries. However, its accuracy in identifying specific arteries affected by vasospasm remains unclear. This study investigates the correlation between elevated MFV and the actual location of vasospasm, considering the influence of adjacent artery vasospasms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a retrospective observational study of patients with subarachnoid hemorrhage who underwent transcranial Doppler monitoring and subsequent angiography between March 2017 and December 2020. The primary exposure was the maximum MFV recorded in the middle cerebral artery (MCA), anterior cerebral artery (ACA), and intracranial internal carotid artery (ICA). The primary outcome was the presence and location of vasospasm, confirmed by angiography. The Kruskal\u2013Wallis test compared MFV distributions among vasospasm groups, and logistic regression evaluated associations between MFV values and vasospasm presence in each artery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Among 367 hemispheres, vasospasm was present in 16%, with 7% involving a single artery and 8% involving multiple arteries. MFV increased not only in arteries directly affected by vasospasm but also in adjacent arteries (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001, Kruskal\u2013Wallis test). MCA vasospasm was associated with increased MCA MFV (odds ratio [OR], 1.036 [95% CI, 1.019\u20131.053],\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). ICA vasospasm was associated with increased ICA MFV (OR, 1.023 [95% CI, 1.006\u20131.040],\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = 0.007). ACA vasospasm, however, was not associated with ACA MFV (OR, 1.011 [95% CI, 0.996\u20131.025],\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = 0.142) but instead correlated with MCA MFV (OR, 1.040 [95% CI, 1.024\u20131.056],\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">MFV elevations occur in both affected and adjacent arteries, suggesting the interconnected response of cerebral arteries to vasospasm. Unlike MCA and ICA, ACA vasospasm does not correlate with ACA MFV but instead with MCA MFV. These findings challenge conventional assumptions about transcranial Doppler interpretation and suggest that MFV increases should be viewed as a general marker of vasospasm rather than an artery\u2010specific indicator.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.124.001645","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T03:06:19Z","timestamp":1751252779000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Elevated Flow Velocity in Transcranial Doppler: Discrepancies Between Actual Vasospasm Locations and Flow Measurements"],"prefix":"10.1161","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6389-7423","authenticated-orcid":false,"given":"Yongwoo","family":"Kim","sequence":"first","affiliation":[{"name":"MedStar Washington Hospital Center","place":["Washington"]},{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Kim","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef D.","family":"Willams","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Withington","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eshetu","family":"Tefera","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute","place":["Hyattsville"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Felbaum","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey C.","family":"Mai","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rizwan A.","family":"Tahir","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai\u2010Hsi","family":"Liu","sequence":"additional","affiliation":[{"name":"MedStar Washington Hospital Center","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocco A.","family":"Armonda","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason J.","family":"Chang","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine","place":["Washington"]},{"name":"MedStar Washington Hospital Center","place":["Washington"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000436"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2006.00083.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.331125071"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/hs1001.097108"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.8.906"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon19966287"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon1996618"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3109\/02688699309023812"},{"key":"e_1_3_2_10_2","first-page":"1237","article-title":"Role of transcranial Doppler monitoring in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage","volume":"44","author":"Vora YY","year":"1999","unstructured":"Vora YY, Suarez\u2010Almazor M, Steinke DE, Martin ML, Findlay JM. Role of transcranial Doppler monitoring in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage. Neurosurgery. 1999;44:1237\u20101247. discussion 1247\u20138.","journal-title":"Neurosurgery"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.13132"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/joacp.JOACP_192_17","article-title":"Monitoring cerebral vasospasm: How much can we rely on transcranial Doppler","volume":"35","author":"Samagh N","year":"2019","unstructured":"Samagh N, Bhagat H, Jangra K. Monitoring cerebral vasospasm: How much can we rely on transcranial Doppler. J Anaesthesiol Clin Pharmacol. 2019;35:12\u201018.","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-021-01331-z"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00234-008-0466-7","article-title":"CT angiography and perfusion imaging in patients with subarachnoid hemorrhage: correlation of vasospasm to perfusion abnormality","volume":"51","author":"Aralasmak A","year":"2008","unstructured":"Aralasmak A, Akyuz M, Ozkaynak C, Sindel T, Tuncer R. CT angiography and perfusion imaging in patients with subarachnoid hemorrhage: correlation of vasospasm to perfusion abnormality. Neuroradiology. 2008;51:85.","journal-title":"Neuroradiology"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011403"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01405268"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.08.004"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000128411.07036.a9"},{"key":"e_1_3_2_19_2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1038\/jcbfm.2014.198","article-title":"Cerebral vasospasm affects arterial critical closing pressure","volume":"35","author":"Varsos GV","year":"2014","unstructured":"Varsos GV, Budohoski KP, Czosnyka M, Kolias AG, Nasr N, Donnelly J, Liu X, Kim D\u2010J, Hutchinson PJ, Kirkpatrick PJ, et\u00a0al. Cerebral vasospasm affects arterial critical closing pressure. J Cereb Blood Flow Metab. 2014;35:285\u2010291.","journal-title":"J Cereb Blood Flow Metab"},{"key":"e_1_3_2_20_2","doi-asserted-by":"crossref","DOI":"10.1111\/jon.70010","article-title":"Transcranial doppler arterial pressure gradient is associated with delayed infarction after subarachnoid hemorrhage","volume":"35","author":"Kim Y","year":"2025","unstructured":"Kim Y, Kim A, Williams JD, Withington C, Tefera E, Gizaw S, Felbaum DR, Mai JC, Liu A, Armonda RA, et\u00a0al. Transcranial doppler arterial pressure gradient is associated with delayed infarction after subarachnoid hemorrhage. J. Neuroimaging. 2025;35:e70010.","journal-title":"J. Neuroimaging."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.005672"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.JNS15428"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.124.001645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T06:09:14Z","timestamp":1757657354000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.124.001645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1161\/SVIN.124.001645"],"URL":"https:\/\/doi.org\/10.1161\/svin.124.001645","relation":{},"ISSN":["2694-5746"],"issn-type":[{"type":"electronic","value":"2694-5746"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2024-10-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e001645"}}