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Doppler transcranial

Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Christina Notarianni, Anil Nanda
BACKGROUND: Traumatic brain injury [TBI] is a leading cause of pediatric morbidity and mortality worldwide and intracranial pressure [ICP] monitoring plays a crucial role in its management. Based on existing literature, the authors review the current practicing non-invasive ICP monitoring devices and their accuracy in predicting raised ICP in pediatric TBI. MATERIALS AND METHODS: A thorough literature search was conducted on PubMed, Medline and Cochrane data base, articles were selected systematically, reviewed completely and relevant data was summarized and discussed...
March 7, 2018: World Neurosurgery
Lori C Jordan, Dionna O Roberts Williams, Mark J Rodeghier, Brittany Covert, Maria R Ponisio, James F Casella, Robert C McKinstry, Michael J Noetzel, Fenella J Kirkham, Emily R Meier, Beng Fuh, Melissa McNaull, Sharada Sarnaik, Suvankar Majumdar, Timothy L McCavit, Michael R DeBaun
In a prospective cohort study, we tested the hypothesis that children with sickle cell anemia (SCA) with normal transcranial Doppler ultrasound (TCD) velocities and without silent cerebral infarcts (SCIs) would have a lower incidence rate of new neurological events (strokes, seizures or transient ischemic attacks) compared to children with normal TCD measurements and SCIs, not receiving regular blood transfusions. Non-randomized participants from the Silent Cerebral Infarct Transfusion (SIT) Trial who had screening magnetic resonance imaging (MRI) of the brain and normal TCD measurements were included...
March 9, 2018: American Journal of Hematology
Masakazu Kotoda, Tadahiko Ishiyama, Kazuha Mitsui, Sohei Hishiyama, Takashi Matsukawa
PURPOSE: Nicorandil has dual properties and acts as a nitric oxide donor and an ATP-sensitive potassium (KATP ) channel opener. Considering its pharmacological profile, nicorandil might exert protective effects on the brain as well as on the heart. The purpose of this study was to directly evaluate the effect of nicorandil on cerebral blood flow (CBF) in mice using a transcranial Doppler method. METHODS: Under general anesthesia, the nicorandil groups received a single-bolus intraperitoneal injection of the respective doses of nicorandil (1, 5, or 10 mg/kg), while the control group received vehicle only...
March 5, 2018: Journal of Anesthesia
Alicia Mattia, M Reza Azarpazhooh, Claudio Munoz, Chrysi Bogiatzi, Mackenzie A Quantz, J David Spence
Objectives: Microembolic signals (MES) on transcranial Doppler (TCD) predict stroke and cognitive decline. Plasma levels of total homocysteine (tHcy), a prothrombotic factor, are higher in patients with microemboli in carotid stenosis and in patients with paradoxical embolism. In this study we assessed the association between the level of tHcy and the number of MES in patients with mechanical heart valves (MHVs). Methods: TCD monitoring was performed to detect MES before and after breathing 100% oxygen and repeated every 2-4 weeks up to six times...
December 2017: Stroke and Vascular Neurology
Emma van der Weijde, Nabil Saouti, Jan Albert Vos, Selma C Tromp, Robin H Heijmen
OBJECTIVES: To evaluate the indications, perioperative strategy and postoperative outcome of surgical left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) covering the LSA. METHODS: Between 2000 and 2017, a total of 101 consecutive patients underwent surgical revascularization of the LSA prior to, concomitant or following TEVAR. Revascularization was performed through a small supraclavicular incision and consisted of a transposition or bypass graft, using intraoperative transcranial Doppler monitoring...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Angela E Rankine-Mullings, Nadine Morrison-Levy, Deanne Soares, Karen Aldred, Lesley King, Susanna Ali, Jennifer M Knight-Madden, Margaret Wisdom-Phipps, Robert J Adams, Russell E Ware, Marvin Reid
This study investigated the association of nutritional and haematological variables with maximum time-averaged mean velocity (TAMV) measured by transcranial Doppler (TCD) velocity and the agreement of classification between two protocols. TCD categories included: normal (<170 cm/s), conditional (170-199 cm/s) and abnormal (≥200 cm/s) based on TAMV in distal internal carotid artery (dICA), middle cerebral artery (MCA), internal carotid bifurcation, anterior and posterior cerebral arteries. Of 358 children with sickle cell anaemia (SCA) examined, the mean age (±standard deviation) was 7·4 ± 2·7 years; 13·1% and 6·7% had conditional and abnormal velocities, respectively...
March 5, 2018: British Journal of Haematology
Sharon L Cheatham, Joanne L Chisolm, Nicole O'Brien
Hypoplastic left heart syndrome (HLHS) palliation may result in altered cerebral blood flow with subsequent neurodevelopmental implications. The purpose of the study was to assess blood flow in the middle cerebral artery (MCA) and investigate the relationship with early neurodevelopmental outcomes in infants with HLHS after hybrid stage I. Transcranial Doppler (TCD) was performed to obtain peak systolic, end-diastolic, and mean velocities, as well as pulsatility index of the MCA in infants with HLHS (n = 18) at baseline and at 2, 4, and 6 months of age...
March 2, 2018: Pediatric Cardiology
Alexander D Wright, Jonathan D Smirl, Kelsey Bryk, Paul van Donkelaar
OBJECTIVE: To determine whether acute sports-related concussion (SRC) exerts differential effects on cerebral autoregulatory properties during systole versus diastole. MATERIALS AND METHODS: One hundred and thirty-six contact-sport athletes tested preseason; 14 sustained a concussion and completed follow-up testing at 72 hours, 2 weeks, and 1 month post-injury. Five minutes of repetitive squat-stand maneuvers induced blood pressure (BP) oscillations at both 0.05 and 0...
2018: Acta Neurochirurgica. Supplement
Solventa Krakauskaite, Corey Thibeault, James LaVangie, Mateo Scheidt, Leo Martinez, Danielle Seth-Hunter, Amanda Wu, Michael O'Brien, Fabien Scalzo, Seth J Wilk, Robert B Hamilton
OBJECTIVE: To determine normal ranges for traditional transcranial Doppler (TCD) measurements for two age groups (14-19 and 20-29 years) and compare to existing literature results. The development of a normal range for TCD measurements will be required for the development of diagnostic and prognostic tests in the future. MATERIALS AND METHODS: We performed TCD on the middle cerebral artery on 147 healthy subjects aged 18.9 years (SD = 2.1) and calculated mean cerebral blood flow velocity (mCBFV) and pulsatility index (PI)...
2018: Acta Neurochirurgica. Supplement
Jonathan D Smirl, Alexander D Wright, Philip N Ainslie, Yu-Chieh Tzeng, Paul van Donkelaar
OBJECTIVE: Cerebral pressure-flow dynamics are typically reported between mean arterial pressure and mean cerebral blood velocity. However, by reporting only mean responses, potential differential regulatory properties associated with systole and diastole may have been overlooked. MATERIALS AND METHODS: Twenty young adults (16 male, age: 26.7 ± 6.6 years, BMI: 24.9 ± 3.0 kg/m2 ) were recruited for this study. Middle cerebral artery velocity was indexed via transcranial Doppler...
2018: Acta Neurochirurgica. Supplement
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
Katarzyna Kaczmarska, Magdalena Kasprowicz, Antoni Grzanka, Wojciech Zabołotny, Peter Smielewski, Despina Afroditi Lalou, Georgios Varsos, Marek Czosnyka, Zofia Czosnyka
OBJECTIVES: The objectives were to compare three methods of estimating critical closing pressure (CrCP) in a scenario of a controlled increase in intracranial pressure (ICP) induced during an infusion test in patients with suspected normal pressure hydrocephalus (NPH). METHODS: We retrospectively analyzed data from 37 NPH patients who underwent infusion tests. Computer recordings of directly measured intracranial pressure (ICP), arterial blood pressure (ABP) and transcranial Doppler cerebral blood flow velocity (CBFV) were used...
2018: Acta Neurochirurgica. Supplement
Sabino J Pietrangelo, Hae-Seung Lee, Charles G Sodini
OBJECTIVE:  Practical deficiencies related to conventional transcranial Doppler (TCD) sonography have restricted its use and applicability. This work seeks to mitigate several such constraints through the development of a wearable, electronically steered TCD velocimetry system, which enables noninvasive measurement of cerebral blood flow velocity (CBFV) for monitoring applications with limited operator interaction. MATERIALS AND METHODS: A highly-compact, discrete prototype system was designed and experimentally validated through flow phantom and preliminary human subject testing...
2018: Acta Neurochirurgica. Supplement
Chiara Robba, Danilo Cardim, Tamara Tajsic, Justine Pietersen, Michael Bulman, Frank Rasulo, Rita Bertuetti, Joseph Donnelly, Liu Xiuyun, Zofia Czosnyka, Manuel Cabeleira, Peter Smielewski, Basil Matta, Alessandro Bertuccio, Marek Czosnyka
BACKGROUND: Non-invasive measurement of intracranial pressure (ICP) can be invaluable in the management of critically ill patients. Invasive measurement of ICP remains the "gold standard" and should be performed when clinical indications are met, but it is invasive and brings some risks. In this project, we aim to validate the non-invasive ICP (nICP) assessment models based on arterious and venous transcranial Doppler ultrasonography (TCD) and optic nerve sheath diameter (ONSD)...
2018: Acta Neurochirurgica. Supplement
Alex O Trofimov, George Kalentyev, Oleg Voennov, Michail Yuriev, Darya Agarkova, Svetlana Trofimova, Vera Grigoryeva
OBJECTIVE: The aim was to evaluate changes in cerebrovascular resistance (CVR) in combined traumatic brain injury (CTBI) in groups with and without intracranial hematomas (IH). MATERIALS AND METHODS: Treatment outcomes in 70 patients with CTBI (42 males and 28 females) were studied. Mean age was 35.5 ± 14.8 years (range, 15-73). The patients were divided into two groups: group 1 included 34 CTBI patients without hematomas; group 2 comprised 36 patients with CTBI and IH...
2018: Acta Neurochirurgica. Supplement
Michael Dobrzeniecki, Alex Trofimov, Denis E Bragin
OBJECTIVE: The main role of the cerebral arterial compliance (cAC) is to maintain the stiffness of vessels and protect downstream vessels when changing cerebral perfusion pressure. The aim was to examine the flexibility of the cerebral arterial bed based on the assessment of the cAC in patients with traumatic brain injury (TBI) in groups with and without intracranial hematomas (IHs). MATERIALS AND METHODS: We examined 80 patients with TBI (mean age, 35.7 ± 12.8 years; 42 men, 38 women)...
2018: Acta Neurochirurgica. Supplement
Marcus Thudium, Ingo Heinze, Richard K Ellerkmann, Tobias Hilbert
BACKGROUND: Postoperative neurological injury still represents a major cause of morbidity after cardiac surgery. Our objective was to compare the limits as well as advantages of routine monitoring tools for the detection of cerebral function and perfusion deficits during cardiopulmonary bypass in a daily clinical setting. METHODS: Adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass were included. Patients received monitoring comprising Bispectral Index (BIS), Near Infrared Spectroscopy (NIRS) and assessment of middle cerebral artery flow velocity (MCAV) using transcranial Doppler (TCD) sonography...
January 31, 2018: Heart Surgery Forum
S J X Murphy, S T Lim, J A Kinsella, D Murphy, H M Enright, Dominick J H McCabe
BACKGROUND: The pathophysiological mechanisms responsible for the disparity in stroke risk between asymptomatic and symptomatic carotid stenosis patients are not fully understood. The functionally important reticulated platelet fraction and reticulocytes could play a role. OBJECTIVES: We performed a prospective, multi-centre, observational analytical study comparing full blood count parameters and platelet production/turnover/activation markers in patients with asymptomatic versus recently symptomatic moderate (≥ 50-69%) or severe (≥ 70-99%) carotid stenosis...
February 23, 2018: Journal of Neurology
Ying Chen, Weihai Xu, Lijuan Wang, Xiaoming Yin, Jie Cao, Fang Deng, Yingqi Xing, Jiachun Feng
BACKGROUND: Neurological deterioration after intracerebral hemorrhage (ICH) is thought to be closely related to increased intracranial pressure (ICP), decreased cerebral blood flow (CBF), and brain metabolism. Transcranial Doppler (TCD) is increasingly used as an indirect measure of ICP, and quantitative EEG (QEEG) can reflect the coupling of CBF and metabolism. We aimed to combine TCD and QEEG to comprehensively assess brain function after ICH and provide prognostic diagnosis. METHODS: We prospectively enrolled patients with severe acute supratentorial (SAS)-ICH from June 2015 to December 2016...
February 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
Alexander D Wright, Jonathan D Smirl, Kelsey Bryk, Michael Jakovac, Paul van Donkelaar
OBJECTIVE: To determine the effects of repetitive subconcussive head trauma on neurovascular coupling (NVC) responses. DESIGN: Prospective cohort study collected between September 2013 and December 2016. SETTING: University laboratory. PARTICIPANTS: One hundred seventy-nine elite, junior-level (age, 19.6 ± 1.5 years) contact sport (ice hockey, American football) athletes recruited for preseason testing. Fifty-two nonconcussed athletes returned for postseason testing...
February 14, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
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