We present the examination technique and normal values of flow velocity from intracranial basal cerebral arteries for a recently developed pulsed Doppler system operating at 2 MHz emitting frequency. Peak systolic, peak diastolic, and mean flow velocity values are analyzed from fast-Fourier transformed(FFT) Doppler spectra at selected depths for 50 presumed normal subjects ranging in age from 18 to 72 years. Interindividual variation is high for peak flow but moderate for mean flow velocity values, which hence are more likely to discriminate normal from abnormal. Flow velocity values within the posterior cerebral attery(PCA) and the basilar artery(BA) are significantly lower than in the anterior cerebral artery(ACA) and the middle cerebral artery(MCA), which is also unique in showing significantly decreasing values with increasing age. Calculated mean flow velocities are 61+/-14 cm/s in the middle cerebral artery(MCA) and 51+/-14 cm/s in the anterior cerebral artery(ACA), and 45+/-11 cm/s in the posterior cerebral artery(PCA) through the temporal window and 43+/-14 cm/s in the basilar artery through the suboccipital window and 15+/-5 cm/s in the ophthalmic artery and 47+/-13 cm/s in the internal carotid artery(lCA) through the transorbital window. A new scanning system is introduced, which we suggest will reduce interindividual variations and improve the accurate separation of nearby vessels, which are major causes of the comparatively large standard deviations at present.
Basilar Artery ; Cerebral Arteries* ; Circle of Willis ; Ophthalmic Artery ; Reference Values* ; Ultrasonography*

BACKGROUND: The basilar artery (BA) may act as an important intracranial collateral to supply hypoperfused anterior circulation. We examined the basilar reserve capacity by using transcranial Doppler sonography (TCD) in patients with occlusive vascular diseases in the anterior circulation (OAC) to determine whether vasomotor reactivity (VMR) of the BA can be affected by the presence of OAC. METHODS: Twenty-five patients were given an MRI including an MRA for minor ischemic symptoms, headache, or dizziness and were divided into two groups according to the presence of OAC. The OAC included occlusions of either the internal carotid artery (ICA) or M1 segment of the middle cerebral artery (MCA). The VMR to hypercapnea was calculated by means of the breath-holding index (BHI). We compared the VMR of the BA between those with and without OAC. RESULTS: Patients with OAC (n=8) showed significantly reduced basilar VMR, compared to that of patients without OAC (n=17) (0.57+/-0.49 versus 1.36+/-0.47, P=0.001). The baseline mean flow velocity of BA was also higher in patients with OAC (70.6+/-24.2cm/s) than those without (38.8+/-11.5 cm/s). However, the baseline pulsatility index did not show differences between patients with and without OAC. CONCLUSIONS: Patients with OAC showed decreased VMR of BA, which can be an easily applicable and useful TCD index for assessing the hemodynamic status in patients with OAC.
Basilar Artery* ; Carotid Artery, Internal ; Dizziness ; Headache ; Hemodynamics ; Humans ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Ultrasonography, Doppler, Transcranial ; Vascular Diseases*

The clinical utility of transcranial doppler ultrasonography (TCD) in cerebrovascular disease has been extended recently. Although number of studies have been performed to define normal reference values of TCD measurements, they have some limitations to be used as reference values which include relatively small number of subjects, lack of data about some cerebral vessels and/or parameters. This study was aimed to obtain clinically useful reference values of TCD measurements with consideration of the influence of age and sex in Korean adults, particularly who are in stroke-prone age group. We measured flow velocities, pulsatility indecies, side-to-side differences and vasomotor reactivities of all intra-and extracranial cerebral arteries using TCD in 209 normal Korean adults (age, 23-78 years; 94 men and 115 women), and analyzed the influence of age and sex on those measurements. With advancing age, subjects showed significant reduction in velocity measurements and increase in pulsatility indecies of most examined arteries. Females showed hight velocities of middle cerebral, internal carotid, vertebral and basilar artery and lower pulsatility indecies of middle cerebral arteries compared with males. Asymmetry measurements including side-to-side differences and asymmetry index, and ,breath holding index testing vasomotor reactivity were also measured and the normal range of those parameters were calculated. Since present study included large number of subjects, and checked paramenters of TCD in both extra- as well as intracranial cerebral arteries, we are convinced that these results can be used as a reference data of TCD measurements in Korean adults.
Adult* ; Arteries ; Basilar Artery ; Breath Holding ; Cerebral Arteries ; Female ; Humans ; Male ; Middle Cerebral Artery ; Reference Values* ; Ultrasonography, Doppler, Transcranial

PURPOSE: To evaluate the cerebral hemodynamic changes during interictal period in patients with epilepsy, we investigated changes in cerebral blood flow velocities by transcranial Doppler sonography (TCD). METHODS: Blood flow velocities and pulsatility indecies were measured in both anterior cerebral arteries, middle cerebral arteries, posterior cerebral arteries, internal carotid arteries, and basilar artery using TCD in 21 patients with epilepsy and 21 age and sex matched normal adults. We also evaluated the effects of seizure type, seizure frequency, EEG findings, and anticonvulsant medication on cerebral blood flow velocities. RESULTS: The blood flow velocities of cerebral arteries were decreased in patients, but the pulsatility indecies weren't different. Cerebral blood flow velocities were influenced by seizure type, EEG findings, or anticonvulsant medication. CONCLUSION: Our study demonstrates that cerebral blood flow velocities might be decreased during interictal period in patients with epilepsy, and suggests that TCD is an useful method for the investigation of the cerebral hemodynamic changes in epilepsy.
Adult ; Anterior Cerebral Artery ; Basilar Artery ; Blood Flow Velocity ; Carotid Artery, Internal ; Cerebral Arteries ; Electroencephalography ; Epilepsy* ; Hemodynamics ; Humans ; Middle Cerebral Artery ; Posterior Cerebral Artery ; Seizures ; Ultrasonography, Doppler, Transcranial

PURPOSE: This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. MATERIALS AND METHODS: Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. RESULTS: A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3TTOF MR angiography, TCD, and CA was high. CONCLUSION: 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.
Angiography* ; Arteries ; Basilar Artery ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Cerebral Infarction* ; Constriction, Pathologic ; Humans ; Middle Cerebral Artery ; Retrospective Studies ; Ultrasonography, Doppler, Transcranial ; Vertebral Artery

We provide the examination technique and the normal values of the cerebral blood flow velocity assessed with the transcranial doppler ultrasound system (TC2-64B, EME) operating at 2MHz in 50 volunteer adult subjects who had no history of neurological illness. Their age ranged from 20 to 58 years and 30 were men. We examined the middle cerebral artery (MCA), the anterior cerebral artery (ACA), the posterior cerebral artery (PCA), the internal carotid (ICAl the opthalmic artery (OPA), and the basilar artery (BA). For each artery we analyzed peak systolic, peak diastolic. And mean flow velocity. Reference values of mean velocities (cm/sec) were 53.2-58.5 for MCA; 48.7-53.8 for ACA; 30.8-33.2 for PCA; . 38.6-42.5 for ICA;11.7-13.1 for OPA;and 34.2-39.9 for BA (95% confidence interval). The velocities correlated inversely with age (p<0.05) arld were significantly lower in the posterior circulation (PCA and BA) than in anterior circulation (MCA, ACA and ICA). There was no difference between both.sexes and between the right and the left side.
Adult ; Anterior Cerebral Artery ; Arteries ; Basilar Artery ; Blood Flow Velocity* ; Humans ; Male ; Middle Cerebral Artery ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery ; Reference Values ; Ultrasonography* ; Volunteers

PURPOSE: The arterial pulsatility index (PI) is measured by transcranial Doppler ultrasonography (TCD) and is postulated to reflect the vascular resistance distal to the artery being examined. An increased PI of the intracranial artery is often reported with diabetes mellitus (DM), old age, hypertension, intracranial hypertension, vascular dementia, and small artery disease. Microvascular complication of DM, which may contribute to cerebral infarction, involves the small perforating artery and may influence the PI of the proximal artery. MATERIALS AND METHODS: We performed a TCD examination in patients with type 2 DM with acute lacunar infarction (DML, n=35), type 2 DM without cerebral infarction (DMO, n=69), and in control cases with no DM or cerebral infarction (control group, n=41). We then compared the TCD findings among these groups. RESULTS: The PI was significantly higher in the DML and DMO groups than in the control group (1.05, 0.93, 0.73. respectively, for the right middle cerebral artery; 1.04, 0.90, 0.73, respectively, for the left middle cerebral artery; 0.97, 0.89, 0.70, respectively, for the basilar artery). The PI was also significantly higher in the DML group than in the DMO group for both middle cerebral arteries. The flow velocity was comparable among the three groups. CONCLUSION: The elevated PI of the intracranial arteries may reflect diabetic cerebral microvascular complications. The PI measurement using TCD may be a useful predictor of lacunar infarction in type 2 DM patients.
Aged ; Basilar Artery/physiology/ultrasonography ; Brain/*blood supply ; Brain Infarction/complications/*ultrasonography ; Diabetes Mellitus, Type 2/*complications ; Diabetic Angiopathies/*ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery/physiology/ultrasonography ; Pulsatile Flow ; Retrospective Studies ; Ultrasonography, Doppler, Transcranial

PURPOSE: The pulsatility index (PI), measured by transcranial Doppler (TCD), is a surrogate marker for distal vascular resistance in cerebral arteries, and elevated plasma total homocysteine (tHcyt) is regarded as a cause of ischemic stroke, including lacunar infarction. We investigated the relationship between the PI of cerebral arteries and plasma tHcyt in patients with lacunar infarction. MATERIALS AND METHODS: Plasma tHcyt level and TCD examination were performed in 94 patients with lacunar infarction. Mean flow velocity (MFV) and PI were assessed at the ipsilateral middle cerebral artery (MCA) and contralateral MCA, relative to the infarction, and the basilar artery (BA). Multivariate regression analysis was conducted between log-transformed tHcyt levels (logHcyt) and the PI of individual arteries. RESULTS: There was a significant correlation between logHcyt and the PI in all tested arteries (ipsilateral MCA: r=0.21, p=0.03; contralateral MCA: r=0.21, p=0.04; BA: r=0.35, p=0.01). In multivariate regression analysis, this significance remained unchanged after adjusting for vascular risk factors, creatinine, hematocrit and platelet count (ipsilateral MCA: beta=0.26, p=0.01; contralateral MCA: beta=0.21, p=0.04; BA: beta=0.39, p=0.001). There was no significant association between logHcyt and MFV of individual arteries. CONCLUSION: A significant association between plasma tHcyt and the PI of cerebral arteries indicates that homocysteine plays a role in the increase of distal arterial resistance in lacunar infarction.
Aged ; Basilar Artery/ultrasonography ; Cerebral Arteries/physiopathology/*ultrasonography ; Female ; Hematocrit ; Homocysteine/*blood ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery/ultrasonography ; Regression Analysis ; Risk Factors ; Stroke, Lacunar/*blood/physiopathology/ultrasonography ; Ultrasonography, Doppler, Transcranial ; Vascular Resistance

This study was performed to examine the influence of isoflurane anesthesia on the pulsatility index (PI) and the peak systolic velocity (PSV) of the blood flow in the basilar artery of dogs by duplex Doppler ultrasonography. Twelve healthy dogs were used to measure the PI and the PSV under the conscious state and isoflurane anesthesia. The pulsatility index (PI) and the peak systolic velocity (PSV) in the basilar artery were measured five times with random intervals. The blood pressure was measured. The PI and PSV values in dogs under isoflurane anesthesia were 1.37 +/- 0.32 and 72 +/- 19 cm/sec, whereas those in the conscious dogs were 1.37 +/- 0.13 and 81 +/- 16 cm/sec, respectively. The indirect mean arterial systolic and diastolic pressures under isoflurane anesthesia were 107 and 51 mmHg, whereas those in the conscious dogs were 133 and 74 mmHg. Though the isoflurane is generally known to induce hypotension, there were no significant differences in the PI and PSV between the isoflurane-anesthetized and the conscious dogs. In conclusion, the isoflurane anesthesia did not influence the PI and PSV in the basilar artery of dogs.
Anesthetics, Inhalation/*pharmacology ; Animals ; Basilar Artery/drug effects/*ultrasonography ; Blood Flow Velocity/drug effects/veterinary ; Blood Pressure/drug effects ; Cerebrovascular Circulation/drug effects ; Dogs/*physiology ; Female ; Isoflurane/*pharmacology ; Male ; Pulsatile Flow/drug effects ; Ultrasonography, Doppler, Duplex/veterinary

OBJECTIVE: To investigate the diagnostic value of transcranial Doppler ultrasound in early stage cerebral arteriosclerosis. METHODS: We selected 50 patients with early cerebral arteriosclerosis as the disease group. At the same time we selected another 50 patients as a control group with no significant symptoms in the nervous system. By 2 MHz pulse Doppler probe through double-temporal windows and pillow windows Basilar artery (BA), the bilateral middle cerebral artery (MCA) was detected. In the TCD spectrum, we selected the spectrum of a single-family cardiac cycle, identified the starting point (ts), pulse-incisure point (ti), end point (te), and the peak velocity (tp), measured the time of the spectrum starting point to the peak velocity (Tp) and calculated the time required for the peak velocity in the share of ventricular systolic (Tp/Ti), the time required for the peak velocity in the share of the whole cardiac cycle (Tp/T). Tp, Tp/Ti and Tp/T were respectively named as time to peak velocity (TPV), peak-time index-1 (PTI-1) and peak-time index-2 (PTI-2). All data were analyzed by SPSS13.0. RESULTS: There was no significant difference in blood vessel velocity, PI, RI and S/D of BA and RMCA (P>0.05) between the control group and the disease group. Compared with the control group, TPV of the BA, LMCA and RMCA significantly extended, PTI-1 and PTI-2 of BA, LMCA and RMCA increased significantly in the disease group (P<0.01). In the disease group, there was no significant correlation between peak time index and PI, S/D (P>0.05). CONCLUSION TPV, PTI-1 and PTI-2 are sensitive indicators of early stage cerebral arteriosclerosis.
Adult ; Basilar Artery ; diagnostic imaging ; Blood Flow Velocity ; physiology ; Case-Control Studies ; Female ; Humans ; Intracranial Arteriosclerosis ; diagnostic imaging ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; Ultrasonography, Doppler, Transcranial