SynthesisCritical care (London, England)2026
Diagnostic accuracy of transcranial Doppler for cerebral vasospasm in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Delayed Neurological Complications After Aneurysmal Subarachnoid Hemorrhage: Time to Reconsider Definitions and Diagnostic Approaches.Neurocritical care · 2026Article
- Point-of-Care Transcranial Doppler Sonography at the Intensive Care Unit-A Practical Review of the Fundamentals.Journal of clinical medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith the increasing adoption of point-of-care ultrasound in neurocritical care, transcranial Doppler (TCD) has gained renewed attention as a bedside monitoring tool for detecting cerebral vasospasm and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Among cerebral vessels, the middle cerebral artery (MCA) is the most frequently evaluated using point-of-care ultrasound. This study aimed to determine the diagnostic accuracy of TCD for detecting cerebral vasospasm that may lead to DCI in the MCA of patients with aSAH.
methodsWe conducted a systematic literature search of MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, ClinicalTrial.gov, and the WHO International Clinical Trials Registry Platform through December 16, 2025, and manually searched the reference lists of relevant articles. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed study quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A meta-analysis was conducted to pool the diagnostic accuracy of TCD for detecting cerebral vasospasm in aSAH. The study protocol was prospectively registered in PROSPERO (CRD42024542692).
resultsAmong the 3100 studies identified, 80 underwent full-text review, and 32 studies including 3594 patients were included in the meta-analysis. Pooled sensitivity and specificity were 76% (95% confidence interval [CI]: 70–81%) and 77% (95% CI, 68–84%), respectively, for cerebral vasospasm. The area under the receiver operating characteristic curve was 0.82. The positive likelihood ratio was 3.4 (95% CI, 2.8–4.7), and the negative likelihood ratio was 0.3 (95% CI, 0.24–0.40). Subgroup analyses showed sensitivity and specificity of 76% (95% CI, 69–81%) and 75% (95% CI, 66–83%) using blood-flow velocity in the MCA (28 studies; n = 3161), 82% (95% CI, 58–94%) and 88% (95% CI, 64–97%) using the Lindegaard ratio (7 studies; n = 1162), and 79% (95% CI, 72–85%) and 82% (95% CI, 66–91%) in studies with low risk of bias (9 studies; n = 1223).
conclusionsTCD demonstrates promising diagnostic accuracy for detecting cerebral vasospasm that may lead to DCI. Incorporating TCD into multimodal neuromonitoring may improve the clinical management of aSAH.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.