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NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS
Official Journal of the Bulgarian Society of Neurosonology and Cerebral Hemodynamics
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Search Results for “search_doc_txt.php” – NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS
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TCCD
'.
1.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 2
,
,
,
Using
TCCD
false negative results were established in 7 patients, 1 had a false positive result.
Subarachnoid haemorrhage was found in 23 patients, 1 suffered from headache and 1 had ischemic cerebral stroke. DSA confirmed the existence of 27 cerebral aneurysms in 20 patients.
Using TCCD false negative results were established in 7 patients, 1 had a false positive result.
The diagnostic sensitivity of TCCDS compared to DSA was 74.1% and the disgnostic specifity – 83.3%
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TCCD
+ 20 1
TCCD+ 20 1
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2.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 2
,
,
,
TCCD
– CTA Fusion Imaging.
TCCD – CTA Fusion Imaging.
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They will undergo to blood tests, ECG, brain CT, carotid US,
TCCD
or TCD.
This is a multicenter, interventional, controlled, randomized study. Patients older than 18 years will be enrolled if presenting with acute IS within 4.5 of symptom onset.
They will undergo to blood tests, ECG, brain CT, carotid US, TCCD or TCD.
Patients should have an occlusion of the middle cerebral artery documented by TCD, TCCD or CTA. Exclusion criteria will be: cerebral hemorrhage on CT and dramatic spontaneous neurologic improvement. Informed consent will be obtained from all patients or their next of kin. Patients will be randomized to receive either tPA alone or tPA
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Patients should have an occlusion of the middle cerebral artery documented by TCD,
TCCD
or CTA.
This is a multicenter, interventional, controlled, randomized study. Patients older than 18 years will be enrolled if presenting with acute IS within 4.5 of symptom onset. They will undergo to blood tests, ECG, brain CT, carotid US, TCCD or TCD.
Patients should have an occlusion of the middle cerebral artery documented by TCD, TCCD or CTA.
Exclusion criteria will be: cerebral hemorrhage on CT and dramatic spontaneous neurologic improvement. Informed consent will be obtained from all patients or their next of kin. Patients will be randomized to receive either tPA alone or tPA
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TCCD
– CTA FUSION IMAGING
TCCD – CTA FUSION IMAGING
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84 patients (age range 20-60 y., 55-female, 29-male) underwent sonography examination using TCD and
TCCD
methods.
84 patients (age range 20-60 y., 55-female, 29-male) underwent sonography examination using TCD and TCCD methods.
Group I-18 patients had RCVS typical acute-onset severe headaches, namely thunderclap headaches reaching peak intensity within 1 min. Group II-19 patientsmigraine in anamnesis, with 1-2 attacks monthly (ultrasound examinations were performed in attack free period), Group III37 patients with severe headache for 1-3 hours, the period
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3.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 2
,
,
,
A Transcranial Doppler (TCD) and/or a Transcranial color-coded Doppler (
TCCD
) are usually performed in the acute phase of IS, to detect and localize the arterial occlusion
In most stroke units the access to ultrasound for the diagnosis of intracranial arterial occlusion is quite simple, due to the wide availability of transcranial Doppler among the clinical tools of vascular neurologists.
A Transcranial Doppler (TCD) and/or a Transcranial color-coded Doppler (TCCD) are usually performed in the acute phase of IS, to detect and localize the arterial occlusion
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4.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 2
,
,
,
EDS, posterior circulation, rotational functional tests,
TCCD
, vertebrobasilar insufficiency
EDS, posterior circulation, rotational functional tests, TCCD, vertebrobasilar insufficiency
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The use of extracranial color-coded duplex (EDS) and transcranial color-coded duplex (
TCCD
) imaging has further enhanced VA, BA and PCA tract imaging and thereby increased diagnostic sensitivity [11].
with conventional neuroimaging, for both intracranial and extracranial segments in the same session. Moreover, new advances for examining the entire intracranial segment have been made even with only transcranial Doppler (TCD) with new software.
The use of extracranial color-coded duplex (EDS) and transcranial color-coded duplex (TCCD) imaging has further enhanced VA, BA and PCA tract imaging and thereby increased diagnostic sensitivity [11].
TCCD has a sensitivity of 72% and a specificity of 94% in patients with basilar or vertebral arteries diseases.
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TCCD
has a sensitivity of 72% and a specificity of 94% in patients with basilar or vertebral arteries diseases.
with conventional neuroimaging, for both intracranial and extracranial segments in the same session. Moreover, new advances for examining the entire intracranial segment have been made even with only transcranial Doppler (TCD) with new software. The use of extracranial color-coded duplex (EDS) and transcranial color-coded duplex (TCCD) imaging has further enhanced VA, BA and PCA tract imaging and thereby increased diagnostic sensitivity [11].
TCCD has a sensitivity of 72% and a specificity of 94% in patients with basilar or vertebral arteries diseases.
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The present research aims to evaluate the role of extracranial duplex-sonography (EDS), transcranial color-coded duplex-sonography (
TCCD
) and RFT in PCD.
Thus, the proper and timed detection of PСD is very important to save lives and to decrease disability.
The present research aims to evaluate the role of extracranial duplex-sonography (EDS), transcranial color-coded duplex-sonography (TCCD) and RFT in PCD.
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This study shows our experience in determining by EDS and
TCCD
whether the “positional" VB ischemia could be associated with any changes of blood flow velocities in the intracranial VA, BA and Р1 segment of РCA during head turning.
Seizures and syncope are common causes for temporary loss of consciousness in РCD. The reticular activating system, which promotes wakefulness, is located in paramedian tegmentum of the upper brainstem. Basilar artery stenosis or occlusion can interrupt the function of these fibers and impair consciousness leading to coma. However, basilar occlusive disease always causes other accompanying findings, such as oculomotor and motor signs [18]. The diagnosis “positional" VB ischemia is present during lateral neck rotation/ extension and is attributed to bony “nipping" of the vertebral artery.
This study shows our experience in determining by EDS and TCCD whether the “positional" VB ischemia could be associated with any changes of blood flow velocities in the intracranial VA, BA and Р1 segment of РCA during head turning.
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The recognition of its peculiar characteristics and the use of
TCCD
are important for proper selection of patients for surgical treatment [19, 20].
Rotational vertebrobasilar ischemia can be very incapacitating because of the temporary impairment of cerebral blood flow to the brainstem, thalamus, and occipital lobes and possible posterior circulation stroke. An accurate diagnosis depends not only on clinical symptoms, but also on hemodynamic and angiographic studies.
The recognition of its peculiar characteristics and the use of TCCD are important for proper selection of patients for surgical treatment [19, 20].
The present study proves that EDS and TCCD are the noninvasive and real-time high sensitive monitoring tools assessing the structural and hemodynamic status of all arteries providing the posterior blood circulation. They can confirm the etiology of hypoperfusion in cerebrovascular insufficiency, TlA or stroke by suggesting a drop in blood flow in the presence of arterial stenosis. These methods give the possibility to evaluate the blood supply in different body positions, to detect the decrease in peak systolic velocity and MFV in BA in patients with positive RFT, estimate the collateral supply, and detect embolic
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The present study proves that EDS and
TCCD
are the noninvasive and real-time high sensitive monitoring tools assessing the structural and hemodynamic status of all arteries providing the posterior blood circulation.
Rotational vertebrobasilar ischemia can be very incapacitating because of the temporary impairment of cerebral blood flow to the brainstem, thalamus, and occipital lobes and possible posterior circulation stroke. An accurate diagnosis depends not only on clinical symptoms, but also on hemodynamic and angiographic studies. The recognition of its peculiar characteristics and the use of TCCD are important for proper selection of patients for surgical treatment [19, 20].
The present study proves that EDS and TCCD are the noninvasive and real-time high sensitive monitoring tools assessing the structural and hemodynamic status of all arteries providing the posterior blood circulation.
They can confirm the etiology of hypoperfusion in cerebrovascular insufficiency, TlA or stroke by suggesting a drop in blood flow in the presence of arterial stenosis. These methods give the possibility to evaluate the blood supply in different body positions, to detect the decrease in peak systolic velocity and MFV in BA in patients with positive RFT, estimate the collateral supply, and detect embolic
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phenomena.
TCCD
monitoring is very important in selecting a treatment strategy and follow-up.
phenomena. TCCD monitoring is very important in selecting a treatment strategy and follow-up.
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Dynamic
TCCD
monitoring is very helpful in identifying TIAs or strokes due to hypoperfusion in patients with PCD [21].
Dynamic TCCD monitoring is very helpful in identifying TIAs or strokes due to hypoperfusion in patients with PCD [21].
Further studies are needed to validate TCCD findings in the heterogeneous group of patients with symptomatic and asymptomatic extraand intracranial arterial stenosis.
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Further studies are needed to validate
TCCD
findings in the heterogeneous group of patients with symptomatic and asymptomatic extraand intracranial arterial stenosis.
Dynamic TCCD monitoring is very helpful in identifying TIAs or strokes due to hypoperfusion in patients with PCD [21].
Further studies are needed to validate TCCD findings in the heterogeneous group of patients with symptomatic and asymptomatic extraand intracranial arterial stenosis.
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EDS and
TCCD
are important tools for estimation of high hemodynamic risk patients with PCD and rotation induced vertebrobasilar ischemia, which predicts a possible posterior circulation TIA or stroke.
EDS and TCCD are important tools for estimation of high hemodynamic risk patients with PCD and rotation induced vertebrobasilar ischemia, which predicts a possible posterior circulation TIA or stroke.
These methods help the proper selection of further treatment strategy.
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5.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 1
,
,
,
Complex use of
TCCD
, 3D TOF-MRangiography and PWI gives all necessary information about the type and hemodynamic parameters of collateral supply in high-grade ICA changes.
Patients with collateral flow via the PComA and reversed OphA flow have more impaired hemodynamic parameters and a higher risk of brain infarctions, than patients with collateral flow via the AComA.
Complex use of TCCD, 3D TOF-MRangiography and PWI gives all necessary information about the type and hemodynamic parameters of collateral supply in high-grade ICA changes.
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The non-invasive evaluation of the collateral circulation status became possible only after introduction into clinical practice of several neuro-angioimaging tools, as Computed Tomography angiography (CTA), Magnetic-resonance angiography ((MRA), Color Doppler sonography (CDUS), Transcranial Color Doppler (
TCCD
) modalities.
The results of several studies have demonstrated that adequate collateral circulation may prevent the development of hemodynamic failure. In contrast, findings from different studies showed that the presence of leptomeningeal collateral flow was associated with an increased risk of future ischemic stroke [1, 4–6]. The actual contribution of the individual collateral pathways is difficult to assess and quantify. Assessment of cerebral hemodynamics can be performed with different techniques.
The non-invasive evaluation of the collateral circulation status became possible only after introduction into clinical practice of several neuro-angioimaging tools, as Computed Tomography angiography (CTA), Magnetic-resonance angiography ((MRA), Color Doppler sonography (CDUS), Transcranial Color Doppler (TCCD) modalities.
All above-mentioned modalities give valuable information about the presence and efficiency of collateral supply in patients with ICA occlusive changes. Several studies have reported significant correlation (r=0,64) between TCCD and MRI findings in the
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Several studies have reported significant correlation (r=0,64) between
TCCD
and MRI findings in the
In contrast, findings from different studies showed that the presence of leptomeningeal collateral flow was associated with an increased risk of future ischemic stroke [1, 4–6]. The actual contribution of the individual collateral pathways is difficult to assess and quantify. Assessment of cerebral hemodynamics can be performed with different techniques. The non-invasive evaluation of the collateral circulation status became possible only after introduction into clinical practice of several neuro-angioimaging tools, as Computed Tomography angiography (CTA), Magnetic-resonance angiography ((MRA), Color Doppler sonography (CDUS), Transcranial Color Doppler (TCCD) modalities. All above-mentioned modalities give valuable information about the presence and efficiency of collateral supply in patients with ICA occlusive changes.
Several studies have reported significant correlation (r=0,64) between TCCD and MRI findings in the
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In the majority of patients with MCA area border-zone infarction, significant decrease of blood flow at the MCA was revealed using
TCCD
; V mean-29.8±8.4 cm/s.
In the majority of patients with MCA area border-zone infarction, significant decrease of blood flow at the MCA was revealed using TCCD; V mean-29.8±8.4 cm/s.
Furthermore, there was also a significant decrease of pulsatile or resistive indexes: PI mean-0.68. In contrary, in patients with cortical infarctions, lacunar infarctions or subcortical leucoencephalopathy hemodynamic changes were not so impaired: Vmean MCA-37.5±9.2 cm/s.
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TCCD
revealed presence of flow in the OA in all cases.
TCCD revealed presence of flow in the OA in all cases.
In a majority of cases with ICA critical
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TCCD
showed that in 16 (22%) patients with collateral flow via the AComA flow parameters in the ipsilateral MCA were near the normal levels – Vmean-44cm/s, PI-0.77.
TCCD showed that in 16 (22%) patients with collateral flow via the AComA flow parameters in the ipsilateral MCA were near the normal levels – Vmean-44cm/s, PI-0.77.
In this group only 2 cases of infarctions (1cortical, 1in deep white matter) were observed. In other 14 patients prevalence of multiple lacunar infarctions and subcortical leucoencephalopathy were distinguished.
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TCCD
showed significant decrease of flow in the MCA (V mean38cm/s, PI-0.69) in this group.
We found that patients without collateral flow via the circle of Willis or flow via the PComA only (n=15) have a high incidence of brain infarction. Despite that in 11 (71%) cases PComA was patent, in 13 (85%) patients presence of infarction was noted: 8 (53%) border-zone and 5 (33%) cortical infarctions of the MCA supply area.
TCCD showed significant decrease of flow in the MCA (V mean38cm/s, PI-0.69) in this group.
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TCCD
showed that in patients with anterograde ACA flow, flow velocity at the ACA (V ACA) was normal or slightly low (Vmean – 44 cm/s, range – 34-53cm/s), hemispheric ratio of velocities in the ACA and MCA was normal – V ACA/V MCA=0.76; but where ACA flow was reversed, V ACA was increased (Vmean – 67.5 cm/s, range – 59-
TCCD showed that in patients with anterograde ACA flow, flow velocity at the ACA (V ACA) was normal or slightly low (Vmean – 44 cm/s, range – 34-53cm/s), hemispheric ratio of velocities in the ACA and MCA was normal – V ACA/V MCA=0.76; but where ACA flow was reversed, V ACA was increased (Vmean – 67.5 cm/s, range – 59-
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