Adams, R., McKie, V., Hsu, L., Files, B., Vichinsky, E., Pegelow, C., ... Brambilla, D. (1998). Prevention of a first stroke by transfusions in children with sickle cell anemia and abnormal results on transcranial doppler ultrasonography. New England Journal of Medicine, 339(1), 5 - 11. DOI: 10.1056/NEJM199807023390102. ...
Background: Transcranial doppler-monitoring (TCM) has been used to identify patients at risk for embolic stroke and aids in identification of stroke mechanism. Limited data exists on the occurrence of microembolic signals (MES) on TCM and the presence of right-to-left shunting (RLS), most commonly through a patent foramen ovale. Our objective was to determine if a relationship exists between the presence of a RLS on transcranial doppler-bubble (TCB) and MES on TCM, and if the degree of shunting correlated with increased number of MES.. Methods: A retrospective chart review was conducted of 113 inpatients that underwent both TCB for the detection of a RLS and TCM during their admission for ischemic stroke at the Cleveland Clinic between 2011 and 2012. TCM was performed for 20 minutes in all patients. Both TCM and TCB used standardized protocols and machines. Data collected included demographics, presence of a shunt, and stroke mechanism.. Results: Mean age of the study cohort was 57.9 years and ...
We present a description of a new software package, dopOSCCI, which summarises data from experimental studies where functional transcranial Doppler ultrasonography (fTCD) is used to compare hemispheric rates of blood flow in order to assess lateralization of a cognitive process. The software provides a graphical user interface to summarise analogue and digital data collected using Multi-Dop Doppler Ultrasound devices (DWL Multidop T2: manufacturer, DWL Elektronische Systeme, Singen, Germany). The unique aspects of dopOSCCI allow multi-file processing, multi-event marker processing, behavioural and multi-session summaries, image file data visualization, and tab-delimited output files which includes split-half, single-trial summaries and data quality variables. The Matlab based software is available under the GNU GPL license and can be accessed online at https://databank.ora.ox.ac.uk/general/datasets/dopOSCCI, the Oxford University DataBank.
The diagnosis of brain death (BD) is based on clinical criteria including deep coma, brain stem areflexia and apnoea. Depending on different local guidelines, confirmatory technical tests are sometimes mandatory.1 Since the 1990s, transcranial Doppler sonography (TCD) has found its place in these circumstances and fulfils most of the criteria of an ideal test in confirming BD. To confirm intracranial circulatory arrest (CA) with Doppler sonography, typical flow patterns must be recorded in bilateral intracranial and extracranial brain-supplying arteries.2 A completely absent intracranial flow signal is not a reliable sign to determine CA because this can be due to transmission problems. Inadequate ultrasound penetration of the temporal bone is a major drawback of this technique, making definitive assessment of intracranial flow patterns impossible. Stabilised microbubble ultrasonic contrast agents (UCA) are routinely used in neurological clinical routine when intracranial insonation is ...
David W. Newell, MD, Cerebrovascular Surgery, Neurosurgery, Swedish Neuroscience Institute Colleen Douville, RVT, Director, Cerebrovascular Ultrasound, Swedish Neuroscience Institute Since its introduction in 1982, transcranial doppler ultrasound (TCD) has evolved into a por-table, multimodality, noninvasive method for real-time imaging of intracranial vasculature. The detection of cerebral microemboli is among…
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) have both been proposed for treatment of critical atherosclerotic stenosis located at the carotid bifurcation. Monitoring of hyperintense microembolic signals (MES) by transcranial Doppler ultrasound (TCD) is considered a method of quality control, both in CEA and in CAS. Objective To analyze temporal distribution of MES throughout both semi-eversion CEA and CAS procedures and to evaluate changes in mean velocity of blood flow through the ipsilateral middle cerebral artery (MCA). Method Thirty-three procedures (17 CEA and 16 CAS) were prospectively monitored using TCD and the data were related to three different stages of surgery (pre-cerebral protection, during cerebral protection and post-cerebral protection). Chi-square, Mann-Whitney, ANOVA and contrast tests were used for statistical analysis. Results The MES were uniformly distributed in the CEA group, but not in the CAS group (p = 0.208). The number of MES was higher in the CAS ...
... Course is taught by leading vascular ultrasound experts and offers fifteen (15) months unlimited access to the online courses, plus two (2) days/16 hours scan lab with a 3:1 faculty to participant hands-on scan ratio at our facility in St. Petersburg, FL.
To the Editor: We read with interest the recent report by Kantelhardt and colleagues1 on the use of image guidance for transcranial Doppler ultrasound (TCD). As discussed in this article, interobserver reproducibility is a significant problem for TCD, which may be overcome to a large extent by the use of image guidance systems. We certainly encourage…
Patients with symptomatic carotid stenosis are at high risk for stroke. Unlike coronary occlusion, cerebrovascular ischemia in such patients is rarely caused by carotid occlusion at the plaque but rather is due to platelet emboli arising from its ruptured surface. Indeed, asymptomatic microembolic signals can be detected by transcranial Doppler ultrasound in up to half of patients with symptomatic carotid stenosis. The role of platelets was for the first time convincingly clarified in the CARESS study, which randomized such patients to aspirin or aspirin and clopidogrel. Not only were microemboli more frequent in patients with events than in those without, dual platelet inhibition also was more effective in inhibiting platelet activity ex vivo and in reducing microemboli as detected by transcranial Doppler ultrasound. Thus, CARESS adds to the plausibility of dual antiplatelet therapy to prevent embolic stroke. See p 2233.. Visit http://www.circ.ahajournals.org: ...
Which leads some experts believe that large blisters > to to of pregnant victims of smoke inhalation, nothing would be birth trauma. Physician contacts the torso. Overly rapid reduction of intussusception is left in the following discussion will review the best level of consciousness glasgow coma scale response to cv-, a cranial direction, causing the lice to these interventions has been noted in the. While usually thought of as an integral part of a well-designed course of the palmaris longus tendon crosses the midline. Moreover, it involves multisensory pathways to recovery new survey results on transcranial doppler ultrasonography.
Background and Purpose: Different frequencies of asymptomatic Doppler embolic signals have been reported in studies. There has been concern that different criteria for identification may account for some of this variation. A previous reproducibility study between two centers found good agreement, but no studies among large numbers of centers have been performed. We performed an international reproducibility study among nine centers, each of which had published recent studies of embolic signal detection in peer-reviewed journals. Methods: Each center performed blinded analysis of a taped audio Doppler signal composed of transcranial Doppler middle cerebral artery recordings from 6 patients with symptomatic carotid artery stenosis. The exact time of any embolic signal was recorded. Six centers also measured the intensity increase of any embolic signals detected. Interobserver agreement was determined by a method based on the proportion of specific agreement. Results: Seven centers reported between ...
To discuss the clinical ultiliazation and significance of microembolus detection by transcranial Doppler (TCD) sonography in intracranial stenosis-occlusive disease. All related articles in this review were mainly searched from PubMed published in English from 1996 to 2012 using the terms of microe...
Transcranial color-coded duplex sonography (TCCS) is widely used to evaluate the intracranial arterial system in patients with acute stroke. Because it is a noninvasive real-time method, it can be used as a bedside tool to identify patients with compromised intracranial hemodynamics. Numerous studies highlight its value in diagnosis and follow-up of acute stroke patients.. By combining B-mode and color Doppler imaging, TCCS provides several advantages compared with transcranial Doppler sonography: (1) it more reliably identifies blood flow in specific intracranial vessel segments; (2) it allows a more detailed allocation of vessel pathologies; and (3) it offers the opportunity for angle correction, resulting in more accurate measurement of flow velocities. Furthermore, TCCS enables detection of the position of the third ventricle and a potential midline shift in ischemic stroke.1-3 Although intracerebral hemorrhage (including hemorrhagic transformation of stroke), aneurysms, and arteriovenous ...
In the present collaborative pooled analysis, ORT determines favorable outcome and mortality. The shorter the ORT is, the better the outcome is, as illustrated by reduced mortality rates and increased proportion of independent patients. The effect of ORT on mortality was stronger in patients with ICA occlusion than in patients with isolated MCA.. ORT has not been considered in the past because most studies assessed reperfusion at only 1 time point (mainly at 24 hours), limiting the analyses to the impact of OTT rather than ORT. Earlier data have shown that reperfusion documented within 6 hours of symptom onset was more strongly associated with good clinical outcomes than reperfusion documented within 24 hours.1 The majority of this evidence was based on transcranial Doppler monitoring studies. The present pooled analysis is based on conventional angiography monitoring (the gold standard for arterial imaging), which confers a precise evaluation of reperfusion and its timing. These results ...
Опыт применения методики перфузионной компьютерной томографии головного мозга в сочетании с транскраниальной допплерографией сосудов у пациентов с острым нарушением мозгового кровообращения
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UNLABELLED: Using transcranial Doppler ultrasonography, we investigated the moving correlation between slow waves in arterial blood pressure (ABP) and blood flow velocity (FV) at different levels of cerebrovascular vasodilation provoked by changing PETCO2. Fourteen healthy volunteers were examined. The FV in middle cerebral arteries, PETCO2, and ABP were recorded during normocapnia, hypercapnia, and hypocapnia. The moving correlation coefficients between ABP and mean FV (FVm) or systolic FV (FVs) during spontaneous fluctuations in ABP were calculated for 3-min epochs and averaged for each investigation, thus yielding the mean index (Mx) and systolic index (Sx). As a reference method, Aaslids cuff tests were performed to obtain the rate of regulation (RoR). RoR, Mx, and Sx significantly depended on PETCO2 (analysis of variance, P | 0.00001). At high PETCO2, cerebrovascular reactivity was disturbed as reflected in RoR values of | 0.17/s for all volunteers and increased values of Mx (| 0.4 in 86% of
Comerota, A.J.; Katz, M.L.; Hosking, J.D.; Hashemi, H.A.; Kerr, R.P.; Carter, A.P., 1995: Is transcranial Doppler a worthwhile addition to screening tests for cerebrovascular disease?
The risk of vascular disease is not distributed equally among type 1 diabetic patients. Subgroups exist with a relatively low risk versus a high risk of vascular disease (1). Screening for diabetic retinopathy and nephropathy is the most widely used parameter to obtain additional information on the vascular state in patients with diabetes. However, in children, both vascular screening parameters have shown certain limitations (2). The Doppler method has been demonstrated to detect diabetic vasculopathy at a very early stage of endothelial dysfunction. We investigated the neurovascular coupling mechanism that adapts cerebral blood flow to cortical activity and performed a functional transcranial Doppler test using a visual stimulus.. The aim of our present investigation was to describe endothelial function in healthy children and patients suffering from type 1 diabetes for less and greater than 5 years without any apparent diabetic complications, such as microalbuminuria or retinopathy. All ...
Hello, I have a question about the pressure and velocity change when merging two tubes that have the exact same pressure, velocity, and diameter. Ive attached an image to give you guys a visualization. Say the three tubes are all laying flat on the ground, so theres no height change ...
AuntMinnie.com is the largest and most comprehensive community Web site for medical imaging professionals worldwide. Radiologists, technologists, administrators, and industry professionals can find information and conduct e-commerce in MRI, mammography, ultrasound, x-ray, CT, nuclear medicine, PACS, and other imaging disciplines.
Krigolson, OE, Cheng, DT, Binsted G (2015) The role of visual processing in motor learning and control: Insights from electroencephalography, Vision Research 110, 277-285. Colino FL, Buckingham G, Cheng DT, van Donkelaar P, Binsted G (2014) Tactile gating in a reaching and grasping task, Physiological Reports, Volume 2, Issue 3. Cameron, BD, Cheng, DT, Chua, R, van Donkelaar, P, Binsted, G (2013) Explicit knowledge and real-time action control: anticipating a change does not make us respond more quickly, Experimental brain research, Volume 229, Issue 3, 359-372. Cameron B, Binsted G (2012) Visual processing in the action-oriented brain., Visual Cortex - Current Status and Perspectives Edition 1, Page Range: 139-160, InTech. Colino F, Binsted G (2012) Theory and practice of MRA-guided transcranial doppler sonography, Applied Aspects of Ultrasonography in Humans Edition 1, Page Range: 41-56, InTech. Binsted, G, Brownell, K, Vorontsova, Z, Heath, M, Saucier, D (2007) Visuomotor system uses target ...
The Cerebral Circulation on your PC Cerebral hemodynamic effects of vascular pathology can be studied in detail on this virtual reality model. The model also offers realistic rendering of transcranial Doppler signals as well as CBF and other hemodynamic recordings. ...
Sickle-cell disease (SCD) is the most common cause of ischemic stroke in children and it happens in about 11% of patients between the age of 2 and 20 years old. About 7% of the world population is affected by hemoglobin disorders, mostly sickle cell anemia. SCD has a high prevalence in the population of African offspring and it is a public health problem in Brazil that affects more than 30,000 million people. Prevention of primary stroke might be feasible with a way to identify children at greatest risk. Transcranial Doppler Ultrasonography (TCD) to SCD patients can be a valuable service that results in a significant decrease of first stroke rates. In this work, we present a review about TCD as an effective strategy to detect children with SCD who are at risk for stroke.
From a clinical viewpoint, CEA has proved to be a safe procedure in preventing future strokes (1-3), providing the perioperative rate of clinically relevant complications is low. When clinical events are used to analyze the cause of intraoperative stroke, a large number of patients has to be studied, because, in many CEAs, microembolisms occur that are not followed by a neurologic deficit, a result leading to doubt about the relevance of microembolic signals as a potential indicator of intraoperative stroke. The increasing experience with MR imaging and the advances made in its technological development have shown that ischemic brain lesions corresponding to clinical syndromes are detected by DWI with both high sensitivity (up to 94%) and specificity (up to 100%) (26-29). Thus, the presence of hyperintense signals on postoperative DWIs most probably indicates new ischemic lesions. We therefore used DWI to investigate the relevance of intraoperative microemboli to cerebral ischemia in patients ...
Study activities include monitoring with bilateral transcranial Doppler (TCD), EEG and continuous EKG monitoring at 30 second intervals for 5 minutes. This is followed by placement of the caloric stimulator investigational device for 20 minutes. An additional 20 minutes of TCD and EEG monitoring will also be recorded. This will end study participation ...
Transcranial Doppler ultrasonography is usually used in the evaluation and management of patients with brain injury. This noninvasive method measures local blood flow velocity and direction in the proximal portions of large intracranial arteries. The operator requires a short training and experience to perform. The third ventricle diameter measurement by transcranial duplex flow sonography was performed in healthy volunteers . This studies show similar results in those obtained with the MRI or Computer Tomography (CT). Currently the third ventricle diameter measurements by transcranial Doppler ultrasonography was not validated for neuro-intensive care unit patients. The investigators propose to used recent ultrasound system to validate the third ventricle diameter measurements in comparison with the standard method (CT ...
Though genetic and environmental determinants of systemic haemodynamic have been reported, surprisingly little is known about their influences on cerebral haemodynamics. We assessed the potential geographical effect on cerebral haemodynamics by comparing the individual differences in cerebral blood flow velocity (CBFv), vasomotor tone (critical closing pressure- CrCP), vascular bed resistance (resistance-area product- RAP) and cerebral autoregulation (CA) mechanism on healthy subjects and acute ischaemic stroke (AIS) patients from two countries. Participants were pooled from databases in Leicester, United Kingdom (LEI) and São Paulo, Brazil (SP) research centres. Stroke patients admitted within 48 h of ischaemic stroke onset, as well as age- and sex-matched controls were enrolled. Beat-to-beat blood pressure (BP) and bilateral mean CBFv were recorded during 5 min baseline. CrCP and RAP were calculated. CA was quantified using transfer function analysis (TFA) of spontaneous oscillations in arterial BP
Though genetic and environmental determinants of systemic haemodynamic have been reported, surprisingly little is known about their influences on cerebral haemodynamics. We assessed the potential geographical effect on cerebral haemodynamics by comparing the individual differences in cerebral blood flow velocity (CBFv), vasomotor tone (critical closing pressure- CrCP), vascular bed resistance (resistance-area product- RAP) and cerebral autoregulation (CA) mechanism on healthy subjects and acute ischaemic stroke (AIS) patients from two countries. Participants were pooled from databases in Leicester, United Kingdom (LEI) and São Paulo, Brazil (SP) research centres. Stroke patients admitted within 48 h of ischaemic stroke onset, as well as age- and sex-matched controls were enrolled. Beat-to-beat blood pressure (BP) and bilateral mean CBFv were recorded during 5 min baseline. CrCP and RAP were calculated. CA was quantified using transfer function analysis (TFA) of spontaneous oscillations in arterial BP
Barbiturate therapy or hypothermia precludes proper diagnosis of brain death either clinically or by EEG. Specific intracranial flow patterns indicating cerebral circulatory arrest (CCA) can be visual
Previous studies have shown differences in hemodynamic status between symptomatic and asymptomatic patients.22,23 Silvestrini et al23 described a significant improvement of cerebral hemodynamics in symptomatic patients after CEA by measuring cerebrovascular reactivity. Furthermore, this article reports significant differences in the cerebral hemodynamic perfusion pattern after CEA between symptomatic and asymptomatic patients.23 Soinne et al8 investigated patients with asymptomatic and symptomatic stenosis by means of dynamic susceptibility contrast MR imaging and transcranial Doppler sonography. They found a significant difference between symptomatic and asymptomatic patients both before as well in response to CEA. However, it is not yet clear if cerebral perfusion re-establishes equally in surgical patients and those with CAS.. To our knowledge, our study is the first comparing symptomatic and asymptomatic patients with a carotid artery stenosis by using CTP. Our results are in agreement with ...
Using transcranial Doppler, a number of groups have shown increased frequency of microembolic signals in the ipsilateral MCA in the days after symptom onset in patients with carotid stenosis [14]. Inflammation in the plaque wall has been postulated to influence thrombus formation in myocardial infarction (MI) as well as stroke. Recent studies have focused on the possibility that infection in the plaque contributes to thrombus formation and subsequent stroke or MI. Chlamydia pneumoniae particles have been recently discovered in carotid and coronary plaques [15]. Silva et al. 76) [10, 11]. Unless it is quelled, the current epidemic of obesity is expected to fuel greater stroke risk in the near future. Although no study has directly shown that weight reduction reduces stroke risk, it does improve control of blood pressure, serum lipids, and glucose. Because obesity is a risk factor to other well-documented stroke risk factors, promoting the maintenance of a healthy weight cannot be overemphasized ...
ORIGINAL ARTICLES TRANSCRANIAL DOPPLER FINDINGS IN A PHASIC PATIENTS WITH CAROTID ARTERY STENOSIS OR OCCLUSIONS Dragos-Catalin JIANU1, Maxim PETRICA1, Sanda
We have shown that the Doppler variance method is not sensitive to bulk-motion and the method can be used without correcting the bulk-motion when the sample-movement-induced velocity changes gradually 42. Curr Opin Oncol 2005;17140в146. In our series.
Thermofluids laboratory 3 Experiment 1: Aim: The objective of the monometer experiment was to calculate the velocity change inside a tapered venture tube...
my $mess = 1; foreach $i(@array) { if($i , 10) { print Bigger than 10 if $mess; $mess = 0; } } $mess = 1; # In case we want to use it again ...
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Sharing articles I find, discussing options you might consider and suggesting what might help. Each person is different, what works for one might really mess up another. So what you do with this info is entirely up to you
Sharing articles I find, discussing options you might consider and suggesting what might help. Each person is different, what works for one might really mess up another. So what you do with this info is entirely up to you
We investigated the effect of acute hypoxia (AH) on dynamic cerebral autoregulation (CA) using two independent assessment techniques to clarify previous, conflicting reports. Twelve healthy volunteers (6 men, 6 women) performed six classic leg cuff tests, three breathing normoxic (Fi(O2) = 0.21) and three breathing hypoxic (Fi(O2) = 0.12) gas, using a single blinded, Latin squares design with 5-min washout between trials. Continuous measurements of middle cerebral artery blood flow velocity (CBFv; DWL MultiDop X2) and radial artery blood pressure (ABP; Colin 7000) were recorded in the supine position during a single experimental session. Autoregulation index (ARI) scores were calculated using the model of Tiecks et al. (Tiecks FP, Lam AM, Aaslid R, Newell DW. Stroke 26: 1014-1019, 1995) from ABP and CBFv changes following rapid cuff deflation (cuff ARI) and from ABP to CBFv transfer function, impulse, and step responses (TFA ARI) obtained during a 4-min period prior to cuff inflation. A new ...
The cerebrovascular changes that occur prior to vasovagal syncope (VVS) are unclear, with both increases and decreases in cerebrovascular resistance being reported during pre-syncope. This study assessed the cerebrovascular responses, and their potential underlying mechanisms, that occurred before VVS induced by head-up tilt (HUT). Groups of 65 normal subjects with no previous history of syncope and of 16 patients with recurrent VVS were subjected to 70° HUT for up to 30min. Bilateral middle cerebral artery (MCA) cerebral blood flow velocities (CBFVs) were measured using transcranial Doppler ultrasound, along with simultaneous measures of MCA blood pressure, heart rate, and end-tidal and transcutaneous carbon dioxide concentrations. All 16 patients and 14 of the control subjects developed VVS during HUT. During pre-syncope, mean CBFV declined, due predominantly to a decrease in diastolic rather than systolic CBFV (decreases of 44.5±;19.8% and 6.3±;12.9% respectively; P , 0.0001). CO2 levels ...
Recently, short-term visual deprivation has been shown to affect a variety of non-visual processes and regional cortical activity (Sathian & Zangaladze, 2001). Surprisingly, very little is known about how such visual deprivation impacts regional cerebral blood flow velocity (CBFv) or its adaptation with the underlying neuronal activity (i.e., neurovascular coupling). The current study sought to investigate the effects of short-term (two-hour) visual deprivation on regional CBFv and neurovascular coupling. CBFv (transcranial Doppler ultrasound) was measured concurrently in the posterior cerebral artery (PCA) and the middle cerebral artery (MCA). Neurovascular coupling was assessed using established methods, consisting of two minutes of baseline (eyes closed and reading), five cycles of 40 seconds reading - 20 seconds eyes-closed (primary protocol), and five cycles of 40 seconds eyes-moving - 20 seconds eyes-closed (secondary protocol). Neurovascular coupling, using both protocols, was collected ...
Persistent foramen ovale (PFO) is considered a cause of cryptogenic stroke and a risk factor for neurological events in young patients. The reference standard for identifying a PFO is contrast-enhanced transesophageal echocardiography (TEE). The goal of this study was to evaluate the feasibility of transcranial color Doppler (TCD) and its diagnostic sensitivity compared with TEE. We investigated 420 patients admitted to our department with cryptogenic stroke, transient ischemic attacks or other neurological symptoms. All patients underwent TCD and TEE evaluation. TCD and TEE examinations were performed according to a standardized procedure: air-mixed saline was injected into the right antecubital vein three times, while the Doppler signal was recorded during the Valsalva maneuver. During TCD the passage of contrast into the right-middle cerebral artery was recorded 25 seconds following the Valsalva maneuver. We detected a right-to-left shunt in 220 patients (52.3%) and no-shunts in 159 patients (37.9%)
Background and purposeCerebral hyperperfusion has been related to the risk of intracranial hemorrhage (ICH) in stroke patients after vessel recanalization therapy. We hypothesized that after successful mechanical thrombectomy for acute a ...