Somatosensory evoked potentials and transcranial color Doppler monitoring in subarachnoid hemorrhage

Federica Ginanneschi; Cesare Vittori; Rossana Tassi; Ilaria Severi; Federico Giuggioli; Caterina Auletta; Francesca Diana; Alessandro Rossi

doi:10.1016/j.jstrokecerebrovasdis.2021.106214

Somatosensory evoked potentials and transcranial color Doppler monitoring in subarachnoid hemorrhage

J Stroke Cerebrovasc Dis. 2022 Feb;31(2):106214. doi: 10.1016/j.jstrokecerebrovasdis.2021.106214. Epub 2021 Dec 16.

Authors

Federica Ginanneschi¹, Cesare Vittori², Rossana Tassi³, Ilaria Severi³, Federico Giuggioli³, Caterina Auletta², Francesca Diana², Alessandro Rossi⁴

Affiliations

¹ Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy. Electronic address: ginanneschi@unisi.it.
² Anesthesia and Neurosurgical Intensive Care Unit, Department of Neurological and Human Movement Sciences, AOUS, Siena, Italy.
³ Stroke Unit, Department of Emergency-Urgency and Transplants, AOUS, Siena, Italy.
⁴ Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.

PMID: 34923433
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106214

Abstract

Objectives: The outcome of patients with subarachnoid hemorrhage (SAH) is broadly influenced by the complications that may result from the hemorrhage. We describe a series of subjects, in which neurophysiological monitoring executed by simultaneous recording of somatosensory evoked potentials (SEPs) and transcranial color Doppler (TCD) was performed to reveal possible, early complications following acute SAH.

Materials and methods: We described the absolute and interhemispheric values of SEPs from the upper limb and TCD examinations of the cerebral arteries in 13 subjects with acute SAH.

Results: In cases with middle cerebral artery (MCA) vasospasm, N20 SEP amplitude absolute values for the hemisphere involved in the vasospasm were much lower than the contralateral ones. The N20 amplitude ratio reduction correlated with reciprocal of MCA mean flow velocity values detected within each patient. In the subjects with early ischemic damage following SAH, the affected hemisphere showed N20 amplitude drop; in addition, the relationship between SEPs and TCD findings was missing.

Conclusion: Our findings emphasize the utility of simultaneous evaluation of SEPs and TCD in SAH follow-up, since the two methods reflect different pathomechanisms of possible secondary brain damage in aneurysmal SAH.

Keywords: Cerebral blood flow; Somatosensory evoked potentials; Subarachnoid hemorrhage; Transcranial color-coded sonography.

MeSH terms

Evoked Potentials, Somatosensory*
Humans
Monitoring, Physiologic* / methods
Subarachnoid Hemorrhage* / complications
Subarachnoid Hemorrhage* / diagnostic imaging
Subarachnoid Hemorrhage* / physiopathology
Ultrasonography, Doppler, Transcranial*