Transcranial Doppler ultrasound CO2 challenge complicated by subarachnoid hemorrhage in patient with moyamoya syndrome.

INTRODUCTION

Studies to assess the hemodynamic status of patients with moyamoya syndrome are often done to determine the need for surgical revascularization. These studies, including transcranial Doppler (TCD) ultrasonography to assess vasomotor reactivity (VMR) to CO(2), are generally considered safe.

CASE

We describe a patient with moyamoya syndrome who experienced a subarachnoid hemorrhage (SAH) following TCD with CO(2) challenge.

CONCLUSION

SAH has not previously been described as a complication of CO(2) challenge in patients with moyamoya syndrome. While such complications are rare, it is important to consider the possibility of harm related to VMR testing in patients with advanced vasculopathy.