Neuroanesthesia & neurocritical care
Diagnostic accuracy of transcranial Doppler for cerebral vasospasm in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis
Authors' conclusion
TCD demonstrates promising diagnostic accuracy for detecting cerebral vasospasm that may lead to DCI.
Study context
- Population
- Patients with aneurysmal SAH (aneurysmal subarachnoid hemorrhage (aSAH))
- Participants
- 3,594 patients · 32 studies
- Comparison
- Transcranial Doppler (TCD) vs reference standard for cerebral vasospasm in the middle cerebral artery (MCA)
- Outcome
- Diagnostic accuracy of TCD for cerebral vasospasm that may lead to delayed cerebral ischemia in the MCA
Methodological detailsQUADAS-2 quality assessment, PRISMA
- QUADAS-2 quality assessment
- PRISMA
Pooled result
As reported in the abstract
Cerebral vasospasm
| Group | Pooled sensitivity | Pooled specificity | AUC | Positive likelihood ratio | Negative likelihood ratio |
|---|---|---|---|---|---|
| TCD | 76% (95% CI 70-81%) | 77% (95% CI 68-84%) | 0.82 | 3.4 (95% CI 2.8-4.7) | 0.3 (95% CI 0.24-0.40) |
TCD
Pooled sensitivity76% (95% CI 70-81%)
Pooled specificity77% (95% CI 68-84%)
AUC0.82
Positive likelihood ratio3.4 (95% CI 2.8-4.7)
Negative likelihood ratio0.3 (95% CI 0.24-0.40)
Further pooled results
| Outcome | Values |
|---|---|
| Blood-flow velocity in the MCA (subgroup) | TCD Sensitivity 76% (95% CI 69-81%) · Specificity 75% (95% CI 66-83%) |
| Lindegaard ratio (subgroup) | TCD Sensitivity 82% (95% CI 58-94%) · Specificity 88% (95% CI 64-97%) |
| Studies with low risk of bias (subgroup) | TCD Sensitivity 79% (95% CI 72-85%) · Specificity 82% (95% CI 66-91%) |
- Blood-flow velocity in the MCA (subgroup): 28 studies; n = 3161
- Lindegaard ratio (subgroup): 7 studies; n = 1162
- Studies with low risk of bias (subgroup): 9 studies; n = 1223
Original publication
Diagnostic accuracy of transcranial Doppler for cerebral vasospasm in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Crit Care. Published 2 February 2026. doi:10.
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