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Transcranial Ultrasonography

Roland Roelz, Christian Scheiwe, Volker A Coenen, Peter C Reinacher
Delayed Cerebral Infarction (DCI) due to Cerebral Vasospasm (CVS) is an important contributor to poor outcome after aneurysmal subarachnoid haemorrhage (aSAH). Despite established risk factors CVS and DCI are unpredictable at the individual patient level. Efficient treatments are lacking. We report a novel rescue therapy for DCI: Access to the basal cisterns by stereotactic catheter ventriculocisternostomy (STX-VCS) and direct cisternal application of the spasmolytic agent Nimodipine. On the basis of individual treatment decisions three aSAH patients who developed CVS underwent STX-VCS...
February 5, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Michelle Elizabeth Favre, Jorge M Serrador
Sex is known to affect the prevalence of conditions such as stroke. However, effects of sex on cerebral blood flow regulation are still not well understood. Critical to this understanding is how fluctuations in hormones across the menstrual cycle affect cerebral autoregulation. We measured autoregulation in early follicular, late follicular, and mid-luteal phases during spontaneous and induced blood pressure oscillations in 26 (13 women) young (26 ± 4 years), healthy individuals. Men participated 3 times, ~1-3 weeks apart...
February 1, 2019: American Journal of Physiology. Heart and Circulatory Physiology
Lucy Beishon, Jatinder S Minhas, Kate Patrick, Iswariya Shanmugam, Claire A L Williams, Ronney B Panerai, Thompson G Robinson, Victoria J Haunton
Background Transcranial Doppler Ultrasonography (TCD) can be utilised to measure the tight coupling of cerebral blood flow velocity (CBFv) in response to cognitive demand by task activation, termed neurovascular coupling. AIMS: To investigate the differences in neurovascular coupling between healthy older (>50 years) and younger (18-49 years) adults in response to cognitive testing. METHODS: Fifty-four older (n=25) and younger (n=29) adults underwent continuous bilateral TCD, beat-to-beat blood pressure (MAP; Finapres), heart rate (HR; electrocardiogram), and end-tidal CO2 (ETCO2; capnography) monitoring...
January 31, 2019: Current Aging Science
Yang Hua, Lingyun Jia, Yingqi Xing, Pinjing Hui, Xuan Meng, Delin Yu, Xiaofang Pan, Yalan Fang, Binbin Song, Chunxia Wu, Chunmei Zhang, Xiufang Sui, Youhe Jin, Jingfen Zhang, Jianwei Li, Ling Wang, Yuming Mu, Jingxin Zhong, Yuhong Zhu, Heng Zhang, Xiaoyu Cai
The aim of this multicenter study was to demonstrate the distribution pattern of atherosclerotic stenosis and its trend with aging between extracranial and intracranial arteries and its distribution between the anterior and posterior circulations in Chinese patients hospitalized with ischemic stroke. In addition, the risk factors for the distribution pattern were illustrated. From June 2015 to May 2016, 9,346 patients with ischemic stroke from 20 hospitals were enrolled. Carotid artery ultrasonography and transcranial color-coded sonography/transcranial Doppler were used to evaluate the extracranial and intracranial arteries...
February 2019: Aging and Disease
O Horlenko, A Lenchenko, G Kossey, A Tomey, O Debretseni
The oral-facial-digital syndrome belongs to a group of hereditary diseases, manifested by multiple birth defects (usually, the face and fingers). At the current stage, there are 14 genetic variations of the oral-facial-digital syndrome. The presence of various abnormalities of the oral cavity, face and fingers is common for all of them, but each syndrome has a specific phenotype or type of inheritance. The etiology of this syndrome is unknown. It is inherited in an X-linked dominant pattern. Aim of the study: to describe and analyze the clinical case of oral-facial-digital syndrome...
December 2018: Georgian Medical News
Sushmita Purkayastha, Farzaneh A Sorond, Sydney Lyng, Justin Frantz, Megan N Murphy, Linda S Hynan, Tonia Sabo, Kathleen Bell
Traumatic brain injury (TBI) is associated with increased risk of later-life neurodegeneration and dementia. However, the underpinning mechanisms are poorly understood and secondary injury resulting from perturbed physiological processes play a significant role. Cerebral vasoreactivity (CVR), a measure of hemodynamic reserve, is known to be impaired in TBI. However, the temporal course of this physiological perturbation is not established. We examined CVR and clinical symptoms on day-3 (T1), day-21 (T2), and day-90 (T3) following concussion in collegiate athletes and cross-sectionally in non-injured controls...
January 29, 2019: Journal of Neurotrauma
Danilo Cardim, Donald E Griesdale, Philip N Ainslie, Chiara Robba, Leanne Calviello, Marek Czosnyka, Peter Smielewski, Mypinder S Sekhon
AIM: Increased intracranial pressure (ICP) in hypoxic ischaemic brain injury (HIBI) can cause secondary ischaemic brain injury and culminate in brain death. Invasive ICP monitoring is limited by associated risks in HIBI patients. We sought to evaluate the agreement between invasive ICP measurements and non-invasive estimators of ICP (nICP) in HIBI patients. METHODS: Eligible consecutive adult (age > 18) cardiac arrest patients with HIBI were included as part of a single center prospective interventional study...
January 7, 2019: Resuscitation
Benjamin Y Tan, Adriel Z Leong, Aloysius S Leow, Nicholas J Ngiam, Bridget S Ng, Manasi Sharma, Leonard L Yeo, Philip A Seow, Chiew S Hong, Young H Chee, Jintao Chen, Zhengdao Du, Lily Y Wong, Amit Batra, Nabin Sarkar, Hock-Luen Teoh, Roger C Ho, Vijay K Sharma
OBJECTIVES: Forest fires in South Asia lead to widespread haze, where many healthy individuals develop psychosomatic symptoms. We investigated the effects of haze exposure on cerebral hemodynamics and new symptoms. We hypothesised that vasoactive substances present in the haze, would lead to vasodilation of cerebral vasculature, thereby altering cerebral hemodynamics, which in turn may account for new psychosomatic symptoms. METHODS: Seventy-four healthy volunteers were recruited, and serial transcranial Doppler (TCD) ultrasonography was performed to record blood flow parameters of bilateral middle cerebral arteries (MCA)...
2019: PloS One
Abhijit V Lele, Arraya Watanitanon, Viharika Lakireddy, Crystalyn Clark-Bell, Anne Moore, Jerry J Zimmerman, Randall M Chesnut, William Armstead, Monica S Vavilala
OBJECTIVES: To examine cerebral autoregulation in children with complex mild traumatic brain injury. DESIGN: Prospective observational convenience sample. SETTING: PICU at a level I trauma center. PATIENTS: Children with complex mild traumatic brain injury (trauma, admission Glasgow Coma Scale score 13-15 with either abnormal head CT, or history of loss of consciousness). INTERVENTIONS: Cerebral autoregulation was tested using transcranial Doppler ultrasound between admission day 1 and 8...
December 6, 2018: Pediatric Critical Care Medicine
Yu Wang, Li Li, Tianlong Wang, Lei Zhao, Hua Feng, Qian Wang, Long Fan, Xuexin Feng, Wei Xiao, Kunpeng Feng
There has been no gold standard for intraoperative monitoring in carotid endarterectomy (CEA) till now. The purpose of the current study was to investigate the value of near-infrared spectroscopy (NIRS) monitoring in CEA and explore the thresholds for intraoperative cerebral hypoperfusion. Eighty-four consecutive patients who underwent CEA surgery in Xuan Wu Hospital of Capital Medical University from August 2015 to June 2016 were enrolled in this study. All patients were intraoperatively monitored by transcranial Doppler ultrasonography (TCD) and NIRS...
December 14, 2018: Cell Transplantation
Tomokazu Kato, Ryo Yanagida, Chiharu Takko, Takuya Kurazumi, Natsuhiko Inoue, Go Suzuki, Yojiro Ogawa, Satoshi Furukawa, Ken-Ichi Iwasaki
BACKGROUND: To develop human space exploration, it is necessary to study the effects of an isolated and confined environment, as well as a microgravity environment, on cerebral circulation. However, no studies on cerebral circulation in an isolated and confined environment have been reported. Therefore, we investigated the effects of a 14-day period of confinement in an isolated environment on dynamic cerebral autoregulation. METHODS: We participated in an isolation and confinement experiment conducted by the Japan Aerospace Exploration Agency in 2016...
December 6, 2018: Environmental Health and Preventive Medicine
Lucy C Beishon, Ronney B Panerai, Thompson G Robinson, Hari Subramaniam, Victoria J Haunton
Background: The incidence of dementia is predicted to rise rapidly, but sensitive diagnostic tests remain elusive. Changes in cerebral blood flow velocity (CBFv) can occur at an early stage of cognitive decline, and can be measured by transcranial Doppler ultrasonography (TCD). Objective: The aim of this study was to characterize the CBFv changes that occur in healthy older adults (HC), mild cognitive impairment (MCI), and Alzheimer's disease (AD), in response to a language task from the Addenbrooke's cognitive examination (ACE-III)...
September 28, 2018: JAD Reports
Gilbert Andrew Pratt, Emily N Hathaway, Peter J Hemond, Douglas K Tadaki, Forest R Sheppard, Jacob J Glaser
BACKGROUND: In combat-related trauma, resuscitation goals are to attenuate tissue hypoxia and maintain circulation. During hemorrhagic shock, compensatory and autoregulatory mechanisms are activated to preserve cerebral blood flow. Transcranial Doppler (TCD) ultrasonography may be an ideal noninvasive modality to monitor cerebral hemodynamics. Using a nonhuman primate (NHP) model, we attempted to characterize cerebral hemodynamics during polytraumatic hemorrhagic shock using TCD ultrasonography...
December 2018: Journal of Surgical Research
Anna Maria Bombardieri, James Beckman, Michael Urban, George Go, A Raffaele De Gaudio, Federico P Girardi, Yan Ma, Stavros G Memtsoudis
BACKGROUND: Prone positioning (PP) is necessary for surgical access during posterior spine procedure. However, physiological changes occur in the PP. Typical findings are a decrease in arterial blood pressure and in cardiac output that could potentially lead to an alteration in cerebral perfusion. Therefore, we decided to study cerebral blood flow velocity (CBFV) with transcranial Doppler ultrasonography to evaluate the effect of the PP on cerebral hemodynamics. METHODS: Twenty-two patients undergoing spine surgery in the PP were studied...
November 9, 2018: Anesthesia and Analgesia
Ferdane Danışman Kalındemirtaş, Hüsniye Birman, Eda Candöken, Sema Bilgiş Gazioğlu, Gülay Melikoğlu, Serap Kuruca
BACKGROUND: Although water pipe smoking is a great public health problem, data regarding the acute and chronic effects and the degree of toxin exposure are limited. While water pipe-related malignancy, pulmonary, infectious, cardiac effects, infertility and biological effects have been described in a meta-analysis, there are no studies in the literature about its neurologic effects. AIMS: The aim was to evaluate water pipe-related acute neurological effects and cerebral blood flow through transcranial doppler ultrasonography and serum s100b protein level measurements...
November 5, 2018: Balkan Medical Journal
Onur Karakayalı, Uygar Utku, Serkan Yılmaz
BACKGROUND: Although water pipe smoking is a great public health problem, data regarding the acute and chronic effects and the degree of toxin exposure are limited. While water pipe-related malignancy, pulmonary, infectious, cardiac effects, infertility and biological effects have been described in a meta-analysis, there are no studies in the literature about its neurologic effects. AIMS: To evaluate water pipe-related acute neurological effects and cerebral blood flow through transcranial doppler ultrasonography and serum s100b protein level measurements...
November 5, 2018: Balkan Medical Journal
Agnieszka Uryga, Magdalena Kasprowicz, Małgorzata Burzyńska, Leanne Calviello, Katarzyna Kaczmarska, Marek Czosnyka
The cerebral arterial blood volume changes (∆Ca BV) during a single cardiac cycle can be estimated using transcranial Doppler ultrasonography (TCD) by assuming pulsatile blood inflow, constant, and pulsatile flow forward from large cerebral arteries to resistive arterioles [continuous flow forward (CFF) and pulsatile flow forward (PFF)]. In this way, two alternative methods of cerebral arterial compliance (Ca ) estimation are possible. Recently, we proposed a TCD-derived index, named the time constant of the cerebral arterial bed (τ), which is a product of Ca and cerebrovascular resistance and is independent of the diameter of the insonated vessel...
October 5, 2018: Journal of Clinical Monitoring and Computing
Nurdan Ozturk Tasar, Pelin Kosger, Nevzat Uzuner, Birsen Ucar
OBJECTIVE: We aimed to investigate the effect of ventricular septal defect (VSD) and heart failure on cerebral blood flow (CBF) in children, whether heart failure treatment improves CBF, and if there is any relationship between CBF and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level. METHOD: Forty children with VSD (13 with heart failure) aged between 1 and 36 months were studied. The control group comprised 25 healthy children in the same age group...
October 2, 2018: Congenital Heart Disease
Jatinder S Minhas, Ronney B Panerai, George Ghaly, Pip Divall, Thompson G Robinson
PURPOSE: International guidelines advocate intensive blood pressure (BP) lowering within 6 hours of acute intracerebral hemorrhage (ICH) to a target systolic BP of 130-140 mm Hg, though more intensive lowering may be associated with adverse outcome. Observational studies suggest impaired cerebral autoregulation (CA) following ICH. Transcranial Doppler ultrasonography (TCD), alongside continuous BP monitoring, provides a noninvasive bedside investigation that offers detailed perspectives on physiological perturbations post-acute ICH...
January 2019: Journal of Clinical Ultrasound: JCU
Laith Mukdad, William Toppen, Yas Sanaiha, Aditya Mantha, Stephanie Bland, Richard Shemin, Peyman Benharash
Cerebral microemboli have been associated with neurocognitive deficits after cardiac operations using cardiopulmonary bypass (CPB). Interventions by the perfusionist and alterations in blood flow account for a large proportion of previously unexplained microemboli. This study compared the incidence of microemboli during cardiac operations using conventional (multidose) and del Nido (single-dose) cardioplegia delivery. Transcranial Doppler ultrasonography was used to detect microemboli in bilateral middle cerebral arteries of 30 adult patients undergoing cardiac operations using CPB and aortic clamping...
September 2018: Journal of Extra-corporeal Technology
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