Subarachnoid hemorrhage is a common manifestation of traumatic brain injury. A clinical deterioration in Glasgow Coma Scale score without an accompanying radiological worsening is suggestive of vasospasm. However, hyperemia could be another possibility which can easily be considered with corroborating transcranial Doppler (TCD) features. This case report reiterates the value of TCD in such instances.
Stiell IG, Wells GA, Vandemheen K, Clement C, Lesiuk H, Laupacis A, et al. The Canadian CT head rule for patients with minor head injury. Lancet 2001;357:1391-6.
Roberts I, Yates D, Sandercock P, Farrell B, Wasserberg J, Lomas G, et al. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): Randomised placebo-controlled trial. Lancet 2004;364:1321-8.
Martin NA, Doberstein C, Alexander M, Khanna R, Benalcazar H, Alsina G, et al. Posttraumatic cerebral arterial spasm. J Neurotrauma 1995;12:897-901.
Miller JD, Dearden NM, Piper IR, Chan KH. Control of intracranial pressure in patients with severe head injury. J Neurotrauma 1992;9 Suppl 1:S317-26.
Kelly DF, Kordestani RK, Martin NA, Nguyen T, Hovda DA, Bergsneider M, et al. Hyperemia following traumatic brain injury: Relationship to intracranial hypertension and outcome. J Neurosurg 1996;85:762-71.
Lindegaard KF, Nornes H, Bakke SJ, Sorteberg W, Nakstad P. Cerebral vasospasm diagnosis by means of angiography and blood velocity measurements. Acta Neurochir (Wien) 1989;100:12-24.
Alexandrov AV. Cerebrovascular Ultrasound in Stroke Prevention and Treatment. Elmsford, NY: Blackwell; 2004.
Chan KH, Dearden NM, Miller JD, Midgley S, Piper IR. Transcranial Doppler waveform differences in hyperemic and nonhyperemic patients after severe head injury. Surg Neurol 1992;38:433-6.
Purkayastha S, Sorond F. Transcranial Doppler ultrasound: Technique and application. Semin Neurol 2012;32:411-20.
