[Diagnosis of delayed cerebral ischaemia and cerebral vasospasm in subarachnoid haemorrhage]. / Diagnóstico de la isquemia cerebral tardía y el vasospasmo cerebral en la hemorragia subaracnoidea.

ABSTRACT

OBJECTIVE: A review of current foundations for the medical diagnosis of vasospam and delayed cerebral ischaemia due to spontaneous subarachnoid haemorrhage. DEVELOPMENT A review of available tests for the investigation of vasospasm (transcraneal Doppler, angiographic methods) and delayed cerebral ischaemia (clinical exam, computerised tomography by X rays, magnetic resonance, emission computerised tomography, electroencephalography, microdialysis) based on type and quality of information, advantages and limitations. Grading and trends for application were also considered for differential diagnosis. CONCLUSIONS: In current clinical practice the most advisable guideline for screening and diagnosis monitoring of vasospasm and delayed cerebral ischaemia is in the first place, based on clinical examination and transcraneal Doppler. The electroencephalographic monitoring, computerised tomography techniques and multi-modal magnetic resonance are justified in specific situations. Digital subtraction angiography is the current gold standard for diagnosis of cerebral vasospasm. There is a need for more and higher quality articles about the utility of diagnostic tests in this context.