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Neurosurgical Applications of Transcranial Doppler Sonography

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Table of Contents

Hemodynamic Principles.- Physiological Blood Flow.- Principles of Ultrasound Doppler Sonography.- Doppler Formula.- Continuous Wave and Pulsed Doppler Instruments.- Insonation Angle.- Frequency Spectrum Analysis.- Vascular Resistance.- Ultrasound Doppler Sonography and Blood Flow Velocity.- Transcranial Doppler Device.- Ultrasound and the Skull.- Technical Data.- Transcranial Doppler Investigation Technique.- Anatomic Considerations.- Insonation Angle, Measured Depths, and Flow Direction.- Compression Tests.- Normal Values.- Blood Flow Velocity Changes Under Physiological Deviations.- Age.- Blood Flow Velocity End-tidal CO2 Partial Pressure.- Orthostasis and TCD.- Body Acceleration.- Valsalva Test and TCD.- Spontaneous Subarachnoid Hemorrhage and Disturbed Intracranial Hemodynamics.- Hemodynamic Considerations in Stenosis and Vasospasm.- Pathomorphology of the Cerebral Arteries After SAH and Vasospasm.- Timing of Aneurysm Operation.- Natural Time Course of Vasospasm.- Patients.- Method.- Results.- Vasospasm and Aneurysm Surgery Within 72 Hours After Subarachnoid Hemorrhage.- Patients.- Vasospasm Within 72 Hours After the Last SAH.- Vasospasm Between Day 4 and Day 31 After SAH.- Clinical Outcome.- Discussion.- Correlation of Angiographically Confirmed Vasospasm and Stenosis with Transcranial Doppler.- Vasospasm and Delayed Aneurysm Surgery.- Intra-aneurysmal Flow Pattern.- Special Case: Vein of Galen-AVM.- Extracranial-Intracranial Bypass.- Method.- Patients.- Results.- Results: STA Compression Tests and TCD.- Results: Special Cases.- Results: Comparison of CBF Measurements with Transcranial Doppler Sonography.- Discussion.- Arteriovenous Malformations.- Feeding Arteries and Steal Effect.- SAH and AVM.- Vascular Resistance Following Surgical Exclusion.- Superselective Embolization and TCD Recordings.- Discussion.- Monitoring of Frequency Spectra in the MCA During Angiography.- Vascular Hemodynamic Response to Meningitis.- Case Reports.- Discussion.- Brain Death and TCD Recordings.- References.

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