M. De Lima Oliveira, M. Mendes Paschoal Junior, K. Almeida Lins, R. Carvalho De Nogueira, M. Krajnyk De Azevedo, E. Santos Junior, M. Jacobsen Teixeira, E. Bor-Seng-Shu
Department of Neurology, University Hospital, University of São Paulo – São Paulo, Brazil

Introduction: The cerebral vasospasm is considered one of the most common and serious complications of Subarachnoid hemorrhage (SAH) can be a cause of neurological ischemic transient or permanent, and contributes to increased rates of morbidity and mortality of patients. Previous studies suggested that intracranial aneurysms can act as sources of distal embolization. Spontaneous thrombus can be observed within the aneurysmal sac, presumably because of turbulence and slow flow. The aim of this study was to describe the detection of some MES during routine vasospasm monitoring by transcranial Doppler (TCD).

Material and Methods: From 2010 to 2011 patients with SAH admitted to the neurology and neurosurgery departments at Hospital das Clínicas, University of São Paulo Medical School (HC/FMUSP), Brazil were investigated in a prospective study. This study was approved by the ethics committee of the HC/FMUSP.

Results: During the study, 105 patients with SAH were admitted, of whom 04 patients entered the study, which detected vasospasm and spontaneous MES. The average age of the patients (mean ± standard deviation) was 59.5 ± 8.34 (range 49-68), and the number of females prevailed with 75 % (3/4). 50% (2/4) were grade II on the Hunt-Hess clinical scale and 75% (3/4) were grade 2 on the Fisher CT scale.

Discussion: TCD ultrasound can detect presence of microembolic signals in patients diagnosed with SAH. Although detection of emboli was relatively rare in this study (4 of 105), rates of emboli occurrence may increase if systematic monitoring is used. The detection MES after SAH surgery may be an indicator for prophylactic antithrombotic treatment.

Key words: brain vasospasm, microembolic signals, subarachnoid hemorrhage, transcranial Doppler.

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