scholarly journals Transcranial Doppler Ultrasound: A Review of the Physical Principles and Major Applications in Critical Care

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Jawad Naqvi ◽  
Kok Hooi Yap ◽  
Gulraiz Ahmad ◽  
Jonathan Ghosh
Keyword(s):  
Transcranial Doppler ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Low Frequency ◽  
Transcranial Doppler Ultrasound ◽  
Arterial Stenosis ◽  
Dynamic Monitoring ◽  
High Temporal Resolution ◽  
Thin Bone ◽  
Cerebral Microembolism

Transcranial Doppler (TCD) is a noninvasive ultrasound (US) study used to measure cerebral blood flow velocity (CBF-V) in the major intracranial arteries. It involves use of low-frequency (≤2 MHz) US waves to insonate the basal cerebral arteries through relatively thin bone windows. TCD allows dynamic monitoring of CBF-V and vessel pulsatility, with a high temporal resolution. It is relatively inexpensive, repeatable, and portable. However, the performance of TCD is highly operator dependent and can be difficult, with approximately 10–20% of patients having inadequate transtemporal acoustic windows. Current applications of TCD include vasospasm in sickle cell disease, subarachnoid haemorrhage (SAH), and intra- and extracranial arterial stenosis and occlusion. TCD is also used in brain stem death, head injury, raised intracranial pressure (ICP), intraoperative monitoring, cerebral microembolism, and autoregulatory testing.

Cerebrovascular Response to Repetitive Visual Stimulation in Interictal Migraine with Aura

Cephalalgia ◽  
2004 ◽  
Vol 24 (9) ◽  
pp. 700-706 ◽  
Author(s):  
K Nedeltchev ◽  
M Arnold ◽  
M Schwerzmann ◽  
A Nirkko ◽  
F Lagger ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Transcranial Doppler ◽  
Blood Flow Velocity ◽  
Visual Stimulation ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Transcranial Doppler Ultrasound ◽  
Healthy Controls ◽  
Cerebral Vasoreactivity

Cortical hypersensitivity and absent habituation to different stimuli have been observed in migraine patients. These features might also be transmitted to the cerebral vasoreactivity, but results are conflicting so far. Transcranial Doppler ultrasound (TCD) was used to assess cerebral blood flow velocity (CBFV) changes in the middle (MCA) and posterior cerebral arteries (PCA) in relation to repetitive checkerboard visual stimulation. Stimulation consisted of 10 consecutive cycles, each comprising 10 s stimulation and 10 s rest. TCD recordings were analysed using stimulus-related averaging algorithm. Data of 19 interictal migraineurs with aura were compared to those of 19 headache-free healthy volunteers. The CBFV increase in PCA and in MCA during visual stimulation was significantly larger and steeper in migraineurs than in controls ( P = 0.017 and P = 0.005). The response in PCA remained stable over the 10 stimulation cycles, both in migraineurs and in controls. The response in MCA was stable only in migraineurs. In controls it decreased over the last 5 stimulation cycles compared with the first 5 cycles ( P = 0.04). Migraineurs with aura exhibit a larger cerebrovascular response to repetitive visual stimulation compared to headache-free subjects. A reduced adaptation to environmental stimuli in migraine is suggested, since there was no habituation in migraineurs in contrast to healthy controls.

scholarly journals Transcranial Doppler Evaluation of the Cerebral Vasculature in Women Patients who Have Migraine with Aura

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3012-3017
Author(s):  
Igor Petrušić ◽  
Ana Podgorac ◽  
Aleksandra Radojičić ◽  
Jasna Zidverc-Trajković
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Migraine With Aura ◽  
Transcranial Doppler ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Transcranial Doppler Sonography ◽  
Cerebrovascular Reactivity ◽  
Breath Holding ◽  
Left And Right

Abstract Background Previous studies suggest that increased cerebrovascular reactivity might be a feature of patients who have migraine with aura (MwA). The correlation between the clinical presentation of migraine with aura and transcranial Doppler parameters remains unclear. Objective The main aim of this study was to explore cerebral blood flow, vascular resistance, and cerebrovascular reactivity in women MwA. Also, the relationships between hemodynamic conditions and aura characteristics are examined. Design Cross-sectional study. Setting Headache Center, Neurology Clinic, Clinical Center of Serbia. Subjects Fifty-four women MwA and 49 healthy controls (HCs). Methods Transcranial Doppler sonography examination was used to determine blood flow mean velocity (MV) and pulsatility index (PI), as well as breath-holding index (BHI), in 15 arterial segments comprising the circle of Willis. Results A total of 54 women MwA and 49 HCs were studied. The PIs of all segments of the left and right middle cerebral arteries and the left and right anterior cerebral arteries were significantly higher in MwA with regards to HCs. Also, both the left and right BHIs were significantly higher in MwA than HCs. In addition, MVs of the right vertebral artery and the first segment of the basilar artery were significantly lower in MwA than HCs. Longer duration of migraine aura showed a weak negative correlation with the PI of the left posterior cerebral artery. Conclusions Our findings suggest increased vessel pulsatility, abnormal cerebrovascular reactivity, and decreased cerebral blood flow velocity in several arterial segments of the Willis circle in women MwA.

Experimental and biological variation of three-dimensional transcranial Doppler measurements

1993 ◽  
Vol 75 (6) ◽  
pp. 2805-2810 ◽  
Author(s):  
L. L. Thomsen ◽  
H. K. Iversen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Transcranial Doppler ◽  
Coefficient Of Variation ◽  
Cerebral Arteries ◽  
Three Dimensional ◽  
Low Frequency ◽  
Control Groups ◽  
Mean Velocity ◽  
Low Frequency Oscillations

A new transcranial Doppler system (3-D Transscan, Eden Medizinische Elektronik) was evaluated in relation to sex, age, intersubject, interobserver, side-to-side, and day-to-day variation. Fifty-eight healthy volunteers participated (aged 18–80 yr). Mean velocity was higher in females than in males and decreased with age. The coefficient of variation in the middle cerebral artery was 26% between subjects, 20% between sides, 16% between days, 13% between observers, and 7% during 5 min. The coefficient of variation was higher in the anterior and posterior cerebral arteries. Bruits were heard in 35 subjects, 24 females and 11 males (P = 0.002). When middle cerebral artery velocity was monitored, high- and low-frequency oscillations were found, with a mean frequency of 5 and 1.6/min, respectively. These variations underline the necessity of standardized conditions and very carefully matched control groups in studies using transcranial Doppler. This is especially important when expected changes are small and easy to overlook, as in studies of normal physiological responses and migraine.

Cerebral hemodynamics in schizophrenia during the Trail Making Test: A functional transcranial Doppler sonography study

2016 ◽  
Vol 33 (S1) ◽  
pp. S107-S107 ◽  
Author(s):  
D. Schuepbach ◽  
S. Egger ◽  
S.C. Herpertz
Keyword(s):  
Transcranial Doppler ◽  
Negative Symptoms ◽  
Doppler Sonography ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Transcranial Doppler Sonography ◽  
Cerebral Hemodynamics ◽  
Trail Making Test ◽  
Trail Making ◽  
Functional Transcranial Doppler Sonography

IntroductionSchizophrenia is a severe mental disorder, with complex symptoms involving psychosis, negative symptoms and cognitive impairment. The Trail Making Test (TMT) has been widely used to assess attention and executive function. Functional transcranial Doppler sonography (fTCD) of basal cerebral arteries allows monitoring of aberrant cerebral hemodynamics during cognitive tasks in this patient group.ObjectivesWe assessed cerebral hemodynamics in the middle cerebral arteries (MCA) using fTCD while patients with schizophrenia and healthy subjects performed the TMT and a control task.MethodsFifteen patients with chronic schizophrenia and 15 healthy controls performed the TMT-A and -B during fTCD measurements of the MCA. Dependent measures were performance, mean cerebral blood flow velocity (MFV) and the lateralization.ResultsPatients demonstrated an overall decreased speed of solution (P = 0.002), and there was no significant effect of age. They showed a significantly increased flow pattern for the TMT-B (P = 0.005). There were no lateralization differences between diagnostic groups.ConclusionsThere was a performance deficit in patients with schizophrenia for both TMT-A and -B that fits well with results of existing literature. The aberrant hemodynamic response supports the idea that cognitive performance elicits an aberrant cerebral hemodynamic correlate. It adds to the notion that fTCD is a valuable tool to correlate psychological paradigms with brain perfusion in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Veränderungen zerebrovaskulärer Perfusionsindices nach Karotis-Thrombendarterektomie

VASA ◽  
1999 ◽  
Vol 28 (4) ◽  
pp. 279-282 ◽  
Author(s):  
Müller ◽  
Behnke ◽  
Walter
Keyword(s):  
Middle Cerebral Artery ◽  
Carotid Endarterectomy ◽  
Cerebral Artery ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Transcranial Doppler Ultrasound ◽  
Blood Velocity ◽  
Hyperperfusion Syndrome ◽  
Middle Cerebral Arteries ◽  
Patients At Risk

Background: To study the pattern of cerebral blood flow velocity and cerebral resistance changes after carotid endarterectomy. Patients and methods: In 81 patients (mean age ± SD, 64 ± 8 years) with unilateral carotid endarterectomy (CEA) the systolic, diastolic and mean blood velocities, and the pulsatility index (PI) were recorded in both middle cerebral arteries preoperatively and repetitively postoperatively with the use of transcranial Doppler ultrasound (TCD). Results: In the middle cerebral artery ipsilateral to CEA mean blood velocity was increased 6 hours (64 ± 25 cm/sec; p < 0.005) and 7 days (54 ± 15 cm/sec; p < 0.05) after CEA and had returned to the preoperative level (49 ± 11 cm/sec) after 3 months. Compared to preoperatively (0.86 ±. 22), the PI was significantly increased at 6 hours examination (1.03 ±. 23, p < 0.005), and remained increased thereafter. A pathologically increased mean blood velocity (> 83 cm/sec) 6 hours after CEA occurred in 11 patients, two of them developed a slight hyperperfusion syndrome. In the contralateral middle cerebral artery, only the diastolic blood velocity showed significant changes (preoperatively, 35 ± 12 cm/sec; 3 months after CEA, 33 ± 8 cm/sec; p < 0.05). Conclusions: Using TCD, hemodynamic changes occur predominantly in the middle cerebral arteries ipsilateral to CEA. Early postoperative TCD studies may be of help to identify patients at risk to develop a hyperperfusion syndrome.

scholarly journals Cerebral lateralisation of first and second languages in bilinguals assessed using functional transcranial Doppler ultrasound

2016 ◽  
Vol 1 ◽  
pp. 15 ◽  
Author(s):  
Clara R. Grabitz ◽  
Kate E. Watkins ◽  
Dorothy V. M. Bishop
Keyword(s):  
Second Language ◽  
Transcranial Doppler ◽  
Cerebral Arteries ◽  
Transcranial Doppler Sonography ◽  
Transcranial Doppler Ultrasound ◽  
Self Report ◽  
Second Languages ◽  
Language History ◽  
Significant Difference ◽  
L1 And L2

Background: Lateralised representation of language in monolinguals is a well-established finding, but the situation is much less clear when there is more than one language. Studies to date have identified a number of factors that might influence the brain organisation of language in bilinguals. These include proficiency, age of acquisition and exposure to the second language. The question as to whether the cerebral lateralisation of first and second languages are the same or different is as yet unresolved. Methods: We used functional transcranial Doppler sonography (FTCD) to measure cerebral lateralisation in the first and second languages in 26 high proficiency bilinguals with German or French as their first language (L1) and English as their second language (L2). FTCD was used to measure task-dependent blood flow velocity changes in the left and right middle cerebral arteries during word generation cued by single letters. Language history measures and handedness were assessed through self-report questionnaires. Results:The majority of participants were significantly left lateralised for both L1 and L2, with no significant difference in the size of asymmetry indices between L1 and L2. Asymmetry indices for L1 and L2 were not related to language history, such as proficiency of the L2. Conclusion: In highly proficient bilinguals, there is strong concordance for cerebral lateralisation of first and second languages.

Transcranial Doppler Ultrasonic Features in Chronic Tension-Type Headache

Cephalalgia ◽  
1992 ◽  
Vol 12 (6) ◽  
pp. 385-386 ◽  
Author(s):  
Thomas-Martin Wallasch
Keyword(s):  
Blood Flow ◽  
Transcranial Doppler ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Transcranial Doppler Ultrasound ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Blood Flow Velocities ◽  
Type Headache ◽  
Flow Velocities

We studied vascular features in patients suffering from chronic headache of the tension-type by means of transcranial Doppler ultrasound (TCD). Blood flow velocities of the basal cerebral arteries and the submandibular extracranial part of the internal carotid artery were compared between 20 chronic tension-type headache sufferers and the same number of age- and sex-matched control subjects. There were no significant differences of ultrasonic features between the groups. Changes in blood flow velocities do not seem to be involved in the pathogenetic mechanisms of chronic tension-type headache.

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