{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T06:15:45Z","timestamp":1792822545343,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Delayed cerebral ischemia (DCI) following an aneurysmal subarachnoid hemorrhage (aSAH) significantly impacts mortality, morbidity, and healthcare costs. This study assessed the diagnostic accuracy of Transcranial Doppler (TCD)-derived biomarkers for predicting DCI via a systematic review and meta-analysis. Included studies had to correctly define DCI and report data on sensitivity, specificity, positive predictive value, and negative predictive value. Univariate or bivariate analyses with a random effects model were used, and risk of bias was evaluated with the Quality Assessment of Diagnostic Accuracy Studies. From 23 eligible articles (n\u2009=\u20092371 patients), three biomarker categories were identified: cerebral blood flow velocities (CBFV), cerebral autoregulation, and microembolic signals (MES). The highest sensitivity (0.86, 95% CI 0.71\u20130.94) and specificity (0.75, 95% CI 0.52\u20130.94) for DCI prediction were achieved with a mean CBFV of 120\u2009cm\/s combined with a Lindegaard ratio. The transient hyperemic response test showed the best performance among autoregulatory biomarkers with a sensitivity of 0.88, (95% CI 0.54\u20130.98) and specificity of 0.82 (95% CI 0.52\u20130.94). MES were less effective predictors. Combining CBFV with autoregulatory biomarkers enhanced TCD\u2019s predictive value. High heterogeneity and risk of bias were noted, indicating the need for a standardized TCD approach for improved DCI evaluation.<\/jats:p>","DOI":"10.1177\/0271678x251313746","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T06:11:14Z","timestamp":1742451074000},"page":"1031-1047","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Systematic review and meta-analysis of transcranial doppler biomarkers for the prediction of delayed cerebral ischemia following subarachnoid hemorrhage"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5754-1268","authenticated-orcid":false,"given":"Hanna","family":"Schenck","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"Mental Health and Neuroscience Institute (MHeNs), Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"van Craenenbroeck","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"van Kuijk","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Gommer","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Institute (MHeNs), Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Veldeman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, RWTH University Hospital Aachen, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasin","family":"Temel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"Mental Health and Neuroscience Institute (MHeNs), Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Aries","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Institute (MHeNs), Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Mess","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Institute (MHeNs), Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel","family":"Haeren","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands"},{"name":"Mental Health and Neuroscience Institute (MHeNs), Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-020-00867-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000103857.13812.9A"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.589275"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019328"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.08.057"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13412"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.034633"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000436"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-023-01812-3"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41984-021-00114-0"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1331812"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2021.731641"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.JNS15428"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.1035086"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.31728\/jnn.2022.00115"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(87)90251-5"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_192_17"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-307711"},{"key":"e_1_3_2_21_2","first-page":"81","article-title":"Cerebral vasospasm after subarachnoid haemorrhage investigated by means of transcranial doppler ultrasound","volume":"42","author":"Lindegaard KF","year":"1988","unstructured":"Lindegaard KF, Nornes H, Bakke SJ, et\u00a0al. Cerebral vasospasm after subarachnoid haemorrhage investigated by means of transcranial doppler ultrasound. Acta Neurochir Suppl (Wien) 1988; 42: 81\u201384.","journal-title":"Acta Neurochir Suppl (Wien)"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2012.189"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01407660"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-015-0125-x"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.12.024"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000349209.69973.88"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.669788"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002696"},{"key":"e_1_3_2_29_2","unstructured":"Federatie Medisch Specialisten. Richtlijn Subarachnoidale Bloedingen. Utrecht: Federatie Medisch Specialisten; 2019. Beschikbaar op: https:\/\/richtlijnendatabase.nl\/richtlijn\/subarachnoidale_bloedingen"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/1971400915626429"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.648980"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jcbfm.9600283"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2014.10.215"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23063102"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-04939-7"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2024.01.043"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13089-018-0095-2"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200010000-00004"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-019-00732-5"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2001.95.3.0393"},{"key":"e_1_3_2_41_2","first-page":"1","article-title":"Association of different transcranial doppler-derived indices of cerebrovascular dynamics with vasospasm and delayed cerebral ischemia in patients suffering from subarachnoid hemorrhage","volume":"8","author":"Papaiaoannou V","year":"2020","unstructured":"Papaiaoannou V, Budohoski K, Placek M, et\u00a0al. Association of different transcranial doppler-derived indices of cerebrovascular dynamics with vasospasm and delayed cerebral ischemia in patients suffering from subarachnoid hemorrhage. Intensive Care Med Exp 2020; 8: 1\u201321.","journal-title":"Intensive Care Med Exp"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2020.10.037"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2008.05.013"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2007.00215.x"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1159\/isbn.978-3-318-01284-2"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-018-0667-2"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-46015-2"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.3.JNS20375"},{"key":"e_1_3_2_49_2","article-title":"Induced hypertension for treatment of delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage","volume":"36","author":"Gathier CS","year":"2010","unstructured":"Gathier CS, Van Den Bergh WM, Beute GN, et\u00a0al. Induced hypertension for treatment of delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage. Intensive Care Med 2010; 36.","journal-title":"Intensive Care Med"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2021.0197"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005396"}],"container-title":["Journal of Cerebral Blood Flow &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X251313746","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0271678X251313746","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X251313746","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:15:28Z","timestamp":1777493728000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0271678X251313746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":50,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1177\/0271678X251313746"],"URL":"https:\/\/doi.org\/10.1177\/0271678x251313746","relation":{},"ISSN":["0271-678X","1559-7016"],"issn-type":[{"value":"0271-678X","type":"print"},{"value":"1559-7016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]}}}