No abstract available.
Brain Death* ; Ultrasonography, Doppler, Transcranial*

49 healthy people without the cardiovascular diseases and cerebral pathology with ages of 17-84, divided 3 groups participated to a study. The results have shown that the maximal and medial speed of the major cerebravascular was gradually reduced as increase of age. The highest reduction of speed found in the vascular in the medial brain, followed by anterior, posterior, basal brain and at last of spine. There is no different between vascular and ages in the speed indicators in the healthy persons.
Hemodynamic Phenomena ; Ultrasonography, Doppler, Transcranial ; Ultrasonics ; Ultrasonography

At the Department of internal neurology of Cho Ray Hospital from Dec 2000 to Jan 2003. 130 patients with acute hemisphere cerebral ischemic stroke were studied. Among them, 34 patients could not evaluated by transcranial Doppler sonography, only 79 had transcranial Doppler sonography (TDS) results and MRI results, which confirmed cerebral infarctus. TDS found 30 normal cases, 28 cases with asymmetric indices reduced, 18 cases increased, 1 case of localized acceleration, 2 cases of obstructive cerebral artery in the side of clinical symptom. MRI found 17 normal cases, 62 cases of stricture of cerebral arteries. Sensitivity and specificity of TDS accounted for 74.2% and 82.4% in comparing with cerebro-vascularogramme made by MRI.
Cerebrovascular Accident ; Brain Ischemia ; Cerebral Angiography ; Ultrasonography, Doppler, Transcranial

The acute stage of an ischemic stroke shows various hemodynamic changes of the involved intracranial arteries. Transcranial Doppler sonography (TCD) is known to be the only tool that can monitor the hemodynamic changes and microembolic signals in the intracranial artery in real-time after an ischemic stroke. Findings of TCD during systemic thrombolytics could inform us of a recanalization of the occluded vessel and the need for further intervention. It has been accepted that ultrasounds have thrombolytic effect on clots when it is used with systemic thrombolytics although the standard protocol and the evidence for its safety are still lacking until now. In this article, we review current utilities of TCD for the management of acute ischemic strokes.
Arteries ; Glycosaminoglycans ; Hemodynamics ; Organothiophosphorus Compounds ; Stroke ; Ultrasonography, Doppler, Transcranial

The confirmatory diagnosis of Moyamoya disease has been obtained by invasive angiographic examination. We report the results of MRI and transcranial doppler sonography of three cases ol Moyamoya disease, which ws disgnosed by clinical and angiography. We think that the diagnosis of Moyamoya disease can be made by noninvasive MRI and transcranial doppler sonography without conventional invasive angiography.
Angiography ; Diagnosis ; Magnetic Resonance Imaging* ; Moyamoya Disease* ; Ultrasonography, Doppler, Transcranial*

No abstract available.
Arteriovenous Fistula* ; Cerebral Infarction ; Intracranial Embolism* ; Ultrasonography, Doppler, Transcranial

The authors performed prospectively the transcranial Doppler monitoring of middle cerebral arteries in 37 patients with ruptured cerebral aneurysm. The entry criteria for the study were confined to the patients who had clinical Grades of 1, 2, or 3, and were operated within 4 days after bleeding. There were several sonographic risk factors of developing delayed ischemic deficits; 1) An early steep increase of flow velocity exceeding 120 cm/sec. 2) An increase of maximum flow velocity more than 140 cm/sec. 3) The flow velocity increasing simultaneously with the onset of delayed ischemic deficit in which case preventive treatment was impossible. 4) Prolonged elevation of flow velocity for more than 7 days despite of aggressive treatment. It seemed to be mandatory to start preventive and aggressive treatment for the asymptomatic patients who showed higher flow velocity than 140 cm/sec. Transcranial Doppler sonography has another potential on deciding the timing of surgery.
Hemorrhage ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Risk Factors ; Ultrasonography ; Ultrasonography, Doppler, Transcranial

BACKGROUND: Transcranial Doppler ultrasonography (TCD) is limited by insufficient ultrasound penetration through the temporal bone. Recent studies have revealed poor temporal bone windows in 5~30% of patients. In about 38% of the patients with poor temporal bone windows, a temporal window was unilaterally absent. The aim of the present study was to compare the mean flow velocities (MFV) of the middle cerebral arteries (MCA) obtained through the ipsilateral temporal bone window with those obtained through the contralateral one using M-mode TCD. METHODS: Eighteen patients (mean age, 28 y; age range, 21~40 y) who had adequate bilateral temporal bone windows were enrolled and 36 MCAs were investigated. The investigators tried to detect the MCA through the ipsilateral and contralateral temporal windows with two 2-MHz probes simultaneously (ipsilateral insonation and contralateral one, respectively). RESULTS: The MCA MFV measured by ipsilateral insonation was 72.58 +/- 9.78 cm/sec and that demonstrated by contralateral insonation was 70.94 +/- 9.79 cm/sec. Even though the differences between MFVs by either side insonation was 2.25~3.94% (0~13.11%) and had significant difference statistically, those were within side-to-side limit of 30% generally considered as abnormal. The mean bitemporal diameter (BTD) was 130.72 +/- 3.75 cm (126~142 cm). We obtained similar waveforms in the reverse direction to those of ipsilateral insonation at 95.33 +/- 5.19 mm of depths (72.97 +/- 4.23% of BTD) during contralateral insonation. CONCLUSIONS: The demonstration of the MCA through the contralateral insonation provides an opportunity to obtain significant mean flow velocities in patients with absent or insufficient temporal bone window unilaterally.
Humans ; Middle Cerebral Artery ; Research Personnel ; Temporal Bone* ; Ultrasonography ; Ultrasonography, Doppler, Transcranial

BACKGROUND: The changes of cerebral hemodynamics during syncope have not been fully evaluated. We investigated the changes in the cerebral blood flow velocity during head-up tilt test (HUT) using transcranial Doppler ultrasonogra-phy (TCD) in patients with neurocardiogenic syncope or presyncope. METHODS: Thirty-three patients with a history of recurrent syncope or presyncope of unknown origin were evaluated using HUT for 30 minutes (baseline tilt test), fol-lowed by an infusion of intravenous isoproterenol if needed. Systolic (SV) and diastolic velocities (DV) of middle cere-bral artery were continuously monitored by TCD. Positive responses were defined as presyncope or syncope with hypotension, bradycardia, or both. RESULTS: Five patients had positive responses during baseline tilt and 14 patients dur-ing the isoproterenol infusion. During the baseline tilt test, there was a 86 +/- 23% drop in DV and a 41 +/- 34% drop in SV in patients with positive responses, and mean changes in those were less than 10% in patients with negative responses (p=.00, p=.00). During the HUT with an isoproterenol infusion, the TCD showed an 80 +/- 18% drop in diastolic velocity in patients with positive responses, and a 47 +/- 10% drop in patients with negative responses (p=.00), However, the change in systolic velocity did not differ. TCD showed three patterns during positive responses: loss of all flow, loss of end-diastolic flow, and a decrease in diastolic velocity. Loss of consciousness occurred in patients with loss of all flow or end-diastolic flow during positive responses. CONCLUSIONS: TCD shows different patterns of changes in cerebral hemody-namics during HUT. TCD can be used to investigate the pathophysiology of neurocardiogenic syncope.
Arteries ; Blood Flow Velocity ; Bradycardia ; Hemodynamics ; Humans ; Hypotension ; Isoproterenol ; Syncope* ; Syncope, Vasovagal ; Ultrasonography, Doppler, Transcranial ; Unconsciousness

To establish management protocol for delayed ischemic deficits(DID), the authors designed a prospective study involving patients with aneurysmal subarachnoid hemorrhage, Fisher group 2 or 3, who had been admitted within 72 hours of the first rupture. The study group consisted of 100 consecutive surgical cases who underwent prophylactic hyperdynamic therapy during the period May 1995 to December 1996. The historical control group was a series of 117 patients, treated between January 1993 and April 1995, who did not undergo the same therapy. DID occurred in seven of 51 patients(13.7%) in the study group who underwent surgery within 72 hours of the first rupture, and in ten of 38 patients(26.3%) in the control group who similarly under surgery. Patients who postoperatively showed evidence of DID were managed as follows ; 1) in those developing DID without increased velocity on transcranial Doppler(TCD) study, hypertension was induced ; 2) in those who on TCD study showed increased flow velocity, cerebral angiography was performed ; 3) those with significant arteriographic vasospasm or delayed cerebral circulation, were intra-arterially infused with papaverine. In conclusion, prophylactic hyperdynamic therapy is an effective tool for the prevention of DID, especially following early surgery. TCD study may not effectively detect DID, but is a useful guide to the selection of management modalities. Intra-arterial papaverine infusion is an effective therapy for angiographic vasospasm and the prevention of DID.
Cerebral Angiography ; Humans ; Hypertension ; Intracranial Aneurysm* ; Papaverine ; Prospective Studies* ; Rupture* ; Subarachnoid Hemorrhage ; Ultrasonography, Doppler, Transcranial