Objective To evaluate the reliability of transcranial doppler (TCD) in detection spasm of middle cerebral artery (MCA),vertebral artery (VA ) and basilar artery (BA).Methods TCD and digital subtraction angiography (DSA) examination were undertaken in 50 patients with subarachnoid hemorrhage.Results Arterial spasm was diagnosed in 26 MCA by DSA,21 of which were detected by TCD at same time.4 MCA were showed by TCD but not confirmed by DSA. The sensitivity and specificity of TCD in diagnosing MCA spasm were 80.8% and 84.0% respectively. Higher sensitivity was revealed in those with severe MCA spasm. DSA also found out asterial spasm of BA in 18 BA,among which 13 arteries were detected by TCD simutaneously.4 BA were diagnosed by TCD but not proved by DSA. The sensitivity and the specificity of TCD in diagnosing BA spasm were 72.2% and 76.5% respectively.28 VA were diagnosed by DSA,among which 20 arteries were proved by TCD.6 VA were detected by TCD but not proved by DSA. The sensitivity and specificity of TCD in diagnosing VA spasm were 71.4% and 76.9% respectively.Conclusion TCD is reliable in diagnosing the spasm of MCA,BA and VA.

Objective To investigate the outcome after ventriculoperitoneal (V-P)shunt for post-traumatic hydrocephalus (PTH). Methods A retrospective study investigated the outcome of 51 patients after head injury, who had undergone V-P shunt due to PTH.The Glasgow outcome scale (GOS),age and intracerebral pressure(ICP) were analyzed. Results Twenty-two of 33 patients with COS 3 or less than 3 scores had clear-cut benefit from V-P shunt,while only 6 of 18 patients with GOS 4 scores did.Tbe GOS before V-P shunt had correlated with the GOS 6 months after operation. The patients with GOS 3 or less than 3 scores had good outcome than patients with COS 4 scores (P<0.05). Patients' age and ICP before the V-P shunt did not influence the outcome (P>0.05 ). Conclusion V-P shunt has much benefit for the patients with PTH, GOS before operation is a best predictive parameter for outcome after V-P shunt.

Objective To investigate regional cerebral blood flow (rCBF) in hypodense areas of the brain after severe traumatic brain injury (sTBI). Methods CT perfusion (CTP) was performed in 42 patients with sTBI during the period of 2011 to 2013. According to the findings of CT scans , hypodense lesions were divided into contusion- or infarction-associated regions. Regional cerebral blood volume (rCBV) of < 15 mL/(100 g·min) was used as the threshold of severe ischemia; rCBF, rCBV, and regional mean transit time (MTT) for the hypodense lesions were analyzed, and the incidence of severe ischemia was compared between the two groups. Results A total of 62 hypodense lesions were identified in the patients. 45 of the 62 hypodense lesions were associated with contusion, and 17 of the lesions were associated with infarction. The mean CT density was significantly lower in the hypodense regions than in the contralateral mirror regions (P<0.05), and there was no significant difference in the mean CT density between the two types of lesions (P > 0.05). Cerebral perfusion was significantly lower in the contusion-associated hypodense regions than in the contralateral mirror regions (P<0.05). In the contrast, cerebral perfusion in the hypodense areas associated with infarction did not significantly differ from that in the contralateral mirror regions (P>0.05). A reduction in rCBF<15 mL/(100 g·min) was found in 25 of the hypodense regions associated with contusion, but only one of those associated with infarction. Conclusions Cerebral perfusion in contusion-associated hypodense areas decreases significantly , but not in infarction-associated hypodense areas. Correct identification of cerebral perfusion in the hypodense areas is helpful for developing therapeutic strategies.