Transcranial Doppler Sonography

Ringelstein, E. B.

doi:10.1007/978-3-642-72996-6_1

Cited by 15 publications

(15 citation statements)

References 17 publications

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“…After 1988, a TC2000 (Eden) device was used. Technical aspects of the TCD examination were the same as those reported elsewhere, 17 with one exception: all the patients were anemic (mean±SD hematocrit, 24±4%), which caused a generalized increase in velocities of 40% above what would be expected based on the age of these patients. 18 The TCD examinations were performed at or near the time of angiography.…”

Section: Methodsmentioning

confidence: 90%

“…17 In one case, we could record no signals on one side and considered this a technical failure due to poor ultrasound transmission. The ultrasound window is generous in patients of this age, and we have come to regard the inability to detect and follow the MCA signal from depths of 55 to 35 mm (from the temporal window) as highly suspicious for abnormality.…”

Section: Discussionmentioning

confidence: 99%

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Transcranial Doppler correlation with cerebral angiography in sickle cell disease.

Adams

Nichols

Figueroa

et al. 1992

Stroke

154

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Background and Purpose: Cerebral infarction in sickle cell disease is associated with arterial narrowing or occlusions of intracranial arteries. Primary stroke prevention would be feasible if a noninvasive screening test could be developed to detect intracranial disease in patients before symptoms develop.Methods: To determine the sensitivity and specificity of transcranial Doppler in detecting significant (>50% lumen diameter reduction) intracranial arterial lesions, we compared transcranial Doppler and cerebral angiography in a primarily young, symptomatic group of 33 patients (18 males and 15 females) with sickle cell disease.Results: From a total of 34 examinations, transcranial Doppler detected significant abnormalities in 26 of 29 (sensitivity 90%, specificity 100%). Five were normal by both techniques. The transorbital examination detected abnormalities in two patients whose studies were otherwise unremarkable.Conclusions: Transcranial Doppler is sensitive and specific for the detection of arterial vasculopathy of sickle cell disease. Screening should include a transorbital examination of the distal internal carotid artery as well as examination using the transtemporal approach. (Stroke 1992;23:1073-1077 KEY WORDS • cerebral infarction • child • anemia, sickle cell • ultrasonics

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Section: Methodsmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Transcranial Doppler correlation with cerebral angiography in sickle cell disease.

Adams

Nichols

Figueroa

et al. 1992

Stroke

154

View full text Add to dashboard Cite

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“…9 However, liver transplantation is associated with marked changes in systemic hemodynamics, and if similarly profound changes are occurring in the cerebral vasculature, interpretation of TCD results becomes difficult. Absolute CBF cannot be measured by TCD without knowledge of the caliber of the middle-cerebral artery, 9,13 and, even in normal controls, there are great inter and intra individual variations in the diameter of the middle-cerebral artery and the blood flow velocities. During liver transplantation, many factors including anesthesia, ventilation, vasoactive drugs, and the release of vasoactive substances by the liver, may act to alter vessel tone, and may complicate the use of TCD.…”

mentioning

confidence: 99%

Cerebral blood flow and metabolism in patients with chronic liver disease undergoing orthotopic liver transplantation

et al. 1998

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Changes in cerebral hemodynamics and metabolism associated with anesthesia and liver transplantation may present particular hazards for patients with cirrhosis. Fifteen patients undergoing liver transplantation were studied, 7 of whom had encephalopathy. Cerebral blood flow (CBF) was measured at the start of surgery, during venovenous bypass and post reperfusion, using a method based on the Kety-Schmidt method. Cerebral metabolism was assessed by measuring the cerebral metabolic rate for oxygen (CMRO 2 ) and the lactate oxygen index (LOI). The cerebral vascular reactivity to carbon dioxide (CO 2 ) was studied during the preanhepatic and post reperfusion phases. During the preanhepatic period, the median CBF was 44 mL/100 g/min at an arterial carbon dioxide tension (PaCO 2 ) of 3.8 kPa. After reperfusion the CBF increased (P F .02) to 102 mL/100 g/min, the arterial hydrogen ion concentration increased from 39 nmol/L to 53 nmol/L (P F .02) and the jugular venous oxygen saturation from 74% to 89% (P F .02). CBF was similar in patients with and without encephalopathy. The cerebral vascular reactivity to CO 2 remained intact, although after reperfusion, the CBF for a given PaCO 2 was greater, and the slope of the CBF/CO 2 response curve diminished. The CMRO 2 was normal in patients without encephalopathy. In the encephalopathic patients, the CMRO 2 was low during all stages of transplantation (0.54, 0.86, 1.24 mL/100 g/min, respectively). Patients with encephalopathy may be at increased risk of hypoxemic brain injury during transplantation. To minimize this possibility, more detailed neurological monitoring may be useful. (HEPATOLOGY 1998;27:369-376.)

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“…Access of ultrasound waves to the intracranial environment is possible through the "ultrasonic windows", namely the temporal, orbital, sub occipital, and submandibular windows. Thus, placing one transducer against these ultrasonic windows allows the obtention of the spectra of blood flow velocity vs time for some cerebral arteries [37] . The previously mentioned arteries can be assessed every 1 mm to 2 mm along their lengths given the pulsed emission ultrasonic waves, which allow controlled modulation depth of the sampling area [38] .…”

Section: Cerebral Blood Flow Monitoringmentioning

confidence: 99%

Multimodal brain monitoring in fulminant hepatic failure

Paschoal¹,

Nogueira²,

Ronconi³

et al. 2016

WJH

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Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation. In the past, neuromonitoring was restricted to serial clinical neurologic examination and, in some cases, intracranial pressure monitoring. Over the years, this monitoring has proven insufficient, as brain abnormalities were detected at late and irreversible stages. The need for real-time monitoring of brain functions to favor prompt treatment and avert irreversible brain injuries led to the concepts of multimodal monitoring and neurophysiological decision support. New monitoring techniques, such as brain tissue oxygen tension, continuous electroencephalogram, transcranial Doppler, and cerebral microdialysis, have been developed. These techniques enable early diagnosis of brain hemodynamic, electrical, and biochemical changes, allow brain anatomical and physiological monitoring-guided therapy, and have improved patient survival rates. The purpose of this review is to discuss the multimodality methods available for monitoring patients with FHF in the neurocritical care setting.

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Transcranial Doppler Sonography

Cited by 15 publications

References 17 publications

Transcranial Doppler correlation with cerebral angiography in sickle cell disease.

Transcranial Doppler correlation with cerebral angiography in sickle cell disease.

Cerebral blood flow and metabolism in patients with chronic liver disease undergoing orthotopic liver transplantation

Multimodal brain monitoring in fulminant hepatic failure

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