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These researchers retrospectively determined the sensitivity and specificity of transcranial Doppler ultrasound (TCD) compared with those of invasive cerebral angiography to detect vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Their gold standard was clinical diagnosis of symptomatic vasospasm. Subjects were 199 patients (55 with symptomatic vasospasm) in a neurologic critical-care unit. The criterion for TCD vasospasm was a mean cerebral blood flow velocity (MCBFV) of >120 cm/sec. False-positive TCD results were minimized by using the so-called Lindegaard velocity ratio between the middle-cerebral and internal-carotid arteries.
The sensitivity of TCD for anterior circulation in patients with symptomatic vasospasm was 73%; specif…