Evaluation of proximal-distal velocity gradient in spastic middle cerebral artery after aneurismal subarachnoid hemorrhage

Delayed cerebral ischemia (DCI) worsens neurological outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). DCI pathogenesis is multifactorial and not completely understood, but vasospasm plays a central role. Transcranial color-coded duplex sonography (TCCDS) is a non-invasive bedside tool to explore cerebral vessels, but specificity is still suboptimal. The aim of this study was to evaluate the proximal-distal gradient of mean cerebral blood flow velocity (CBF-V) in middle cerebral artery (MCA) as a possible indicator of critical vasospasm.