• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.20-24
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• 2012

Background: Migraine patients can be sensitive to external or internal stimuli, such as light, noise, or hormonal changes. Using transcranial Doppler ultrasonography (TCD) with breath-holding method, we evaluated the changes of cerebrovascular reactivity (CVR) to hypercapnia in women with migraine without aura between fasting and postprandial period. Methods: Twelve women with migraine without aura and the same number of age and sex-matched healthy controls with no significant history of headache participated in this study. Using TCD examinations, we studied mean flow velocity in middle cerebral artery with better temporal window. Each subject was examined consecutively before and after a standard meal, together with serum glucose level and blood pressure. CVR was evaluated with breath-holding index (BHI). Results: Postprandial-BHI (mean+SD) was significantly higher than fasting-BHI (mean+SD) in patients group but not in controls (in patient group; postprandial-BHI=1.38, fasting-BHI=1.08, in control group; postprandial-BHI=1.25, fasting-BHI=1.18, P=0.021 and 0.239, respectively). After meal, serum glucose level was significantly enhanced but blood pressure was not in both groups. Serum glucose level of patients showed a tendency of mild positive correlation with BHIs (${\gamma}$=0.448, P=0.032). Conclusions: Although exact mechanisms are unclear, cerebrovascular reactivity of some women with migraine without aura may be influenced by prandial state.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.3
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• pp.219-226
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• 2023

Transcranial doppler ultrasonography (TCD) applies a low frequency of 2 MHz to measure the blood flow velocity and waveform within the skull. Medical technologists at several hospitals are conducting these examinations, and education is being imparted in many schools and academic societies. However, the skill of the tester is of utmost importance when performing TCD. Technicians who are conducting the procedure for the first time have trouble locating the blood vessels, and some experienced personnel are worried because too many blood vessels are present. Since this procedure does not directly look at and measure blood vessels, there are several limitations and difficulties. Therefore, this study aims to provide some help by introducing precautions and suggestions for TCD technicians conducting the test.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.70-75
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• 1999

Trancranial Doppler(TCD) monitoring is a new application of ultrasonography which allows the nonivasive detection of blood flow velocity in the horizontal (M1) segment of the middle cerebral artery (MCA) and detects microembolic phenomena in the cerebral circulation. Recent studies emphasized the potential of using this technique in vascular surgery (carotid endarterectomy, cardiopulmonary bypass), interventional and intensive care setting. Although the disparity between CBF and blood flow velocity and number of microemboli could be used to prevent cerebral ischemic and embolism based on clinical studies. A reduction of more than 60% of MCA can reflex hemodynamic ischemic state and acoustic feedback of high intensity transient signals(HITS) from the TCD monitoring unit has a direct influence on surgical technique. TCD monitoring can immediately provide information about thromboembolism and hemodynamic changes, which may be a useful tool in the study and prevention of stroke.

• Journal of Oriental Neuropsychiatry
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• v.15 no.2
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• pp.173-180
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• 2004

Objectives : The purpose of this study is to investigate the change of cerebral blood flow velocity by different types of suggestion in normal subject. Methods : Suggestion of ascending qi inducement and descending qi inducement which were recomposed from autogenic training, was operated on 60 normal subjects individually. Then cerebral blood flow velocity was examined by Transcranial doppler ultrasonography(TCD) each 5 minutes before and after suggestion. Results : The result shows that cerebral blood flow(CBF) velocity was increased significantly in suggestion of ascending qi inducement and CBF velocity was decreased significally after 1 minute in suggestion of descending qi inducement. Conclusion : Suggestion could have affected to CBF velocity, and also different types of suggestion could have affected to the change of brain blood flow. Various clinical studies should be completed on patients in the future.

• Journal of Chest Surgery
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• v.49 no.1
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• pp.22-28
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• 2016

Background: Carotid endarterectomy (CEA) with selective shunting is the surgical method currently used to treat patients with carotid artery disease. We evaluated the incidence of major postoperative complications in patients who underwent CEA with selective shunting under transcranial Doppler (TCD) at our institution. Methods: The records of 45 patients who underwent CEA with TCD-based selective shunting under general anesthesia from November 2009 to June 2015 were reviewed. The risk factors for postoperative complications were analyzed using univariate and multivariate analysis. Results: Preoperative atrial fibrillation was observed in three patients. Plaque ulceration was detected in 10 patients (22.2%) by preoperative computed tomography imaging. High-level stenosis was observed in 16 patients (35.5%), and 18 patients had contralateral stenosis. Twenty patients (44.4%) required shunt placement due to reduced TCD flow or a poor temporal window. The 30-day mortality rate was 2.2%. No cases of major stroke were observed in the 30 days after surgery, but four cases of minor stroke were noted. Univariate analysis showed that preoperative atrial fibrillation (odds ratio [OR], 40; p=0.018) and ex-smoker status (OR, 17.5; p=0.021) were statistically significant risk factors for a minor stroke in the 30-day postoperative period. Analogously, multivariate analysis also found that atrial fibrillation (p<0.001) and ex-smoker status (p=0.002) were significant risk factors for a minor stroke in the 30-day postoperative period. No variables were identified as risk factors for 30-day major stroke or death. No wound complications were found, although one (2.2%) of the patients suffered from a hypoglossal nerve injury. Conclusion: TCD-based CEA is a safe and reliable method to treat patients with carotid artery disease. Preoperative atrial fibrillation and ex-smoker status were found to increase the postoperative risk of a small embolism leading to a minor neurologic deficit.

• Annals of Clinical Neurophysiology
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• v.20 no.2
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• pp.105-108
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• 2018

Persistent left superior vena cava (PLSVC) is a common venous anomaly of the thorax and usually drains into the right atrium. Less often it drains into the left atrium and has previously been related to ischemic stroke. We report a case of PLSCV that founded during ischemic stroke evaluation in a 77-year-old woman which was detected on transesophageal echocardiography (TEE) and transcranial Doppler ultrasonography (TCD) with saline agitated test and computed tomography.

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.950-961
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• 2008

Objectives : The purpose of this study was to compare cerebral biood flow between hypertensives and normotensives using transcranial doppler ultrasonography (TCD). Methods : I investigated cerebral blood flow of 72 hypertensives and 127 normotensives. To evaluate the cerebral blood flow, I measured the systolic peak velocity(Vs) and mean How velocity (Vm) of the middle cerebral artery(MCA), anterior cerebral artery(ACA), posterior cerebral artery(PCA), basilar artery(BA), and internal carotid artery(ICA) in the two groups using TCD. Result : 1. There was a decrease in the Vs and Vm of all examined vessels of hypertensives in comparison with normotensives. There was a significant difference in the Vs of ACA and Vm of ACA, PCA, ICA. 2. In males, there was a decrease in the Vs of ACA, PCA, ICA and Vm of MCA, ACA, PCA, ICA of hypertensives in comparison with normotensives. However, there was no significant difference in the Vs or Vm of all examined vessels. 3. In females, there was a decrease in the Vs and Vm of all examined vessels of hypertensives in comparison with normotensives. There was a significant difference in the Vs of MCA, ACA and BA and Vm of ACA, PCA and BA. 4. In 30-49 year-olds, there was a decrease in the Vs and Vm of all examined vessels of hypertensives in comparison with normotensives. There was a significant difference in the Vs of ACA and Vm of ACA. 5. In 50-69 year-olds, there was a decrease in the Vs of ACA, PCA, BA, ICA and Vm of all examined vessels of hypertensives in comparison with normotensives. However, there was no significant difference in the Vs or Vm of all examined vessels. 6. In 70-89 vests old. there was a decrease in the Vs. Vm of PCA, BA, ICA of hypertensives in comparison with normotensives. But, there was no significant difference in the Vs, Vm of all examined vessels. Conclusions : There was a significant difference in the cerebral blood now velocity between hypertensives and normotcnsives. These results suggest that blood pressure has influence on cerebral blood flow.

• Journal of Acupuncture Research
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• v.18 no.6
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• pp.105-113
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• 2001

Objective : This study was performed to evaluate the effect of acupuncture on cerebral blood flow by Transcranial Doppler Ultrasonography(TCD) Method : Monitoring of TCD was examined in 11 healthy women volunteer(mean $age:\;24.5{\pm}2.9\;\;years$) before, during and after acupuncture on Paekoe(GV20). Mean velocity, pulsatility index, systolic velocity and diastolic velocity values are analyzed from DWL. MDX4 at different depths of both middle cerebral artery. Results : The results showed a significant(p<0.05; Friedman test & Wilcoxon signed ranks test) increase in mean velocity, systolic velocity and diastolic velocity decrease in pulsatility index, which was measured at different depths of both middle cerebral artery. Conclusion : These results suggest that acupuncture could have a specific effect on cerebral blood flow.

• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.434-440
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• 2006

Objective : The purpose of this study is to examine the influence of cranioplasty on dynamics of cerebral blood flow[CBF] and cerebrovascular reserve capacity[CVRC], and to investigate the usefulness of single photon emission computed tomography [SPECT] as a prognostic factor for neurological improvement after cranioplasty. Methods : Between March 2003 and December 2005, a prospective study was performed on 24 patients who had undergone total 25 cranioplasty operations. Cerebral blood flow velocities in the middle cerebral artery[MCA] and internal carotid artery[ICA] were obtained by transcranial Doppler ultrasonography[TCD]. The CVRC was assessed by SPECT in the natural state and after stimulation with 1g of acetazolamide. Neurological improvement after cranioplasty was compared between patients who showed hyperactivity to acetazolamide-activated SPECT [Group 1, n=7] and hypoactivity to acetazolamide-activated SPECT [Group 2, n=17]. These measurements were obtained two weeks prior to and two weeks after cranioplasty. Results : The blood flow velocities at the opposite site to the cranioplasty as well as at the cranioplasty site were significantly increased [P<0.05]. Compared with Group 2, there was significant increase in CBF and neurological improvement after cranioplasty in Group 1. Conclusion : Among patients with surgical bony defects, the patients who had normal reactivity of the CVRC showed a significant increase in CBF and neurological improvement after cranioplasty. The authors suggest that CVRC measurement prior to surgery may be an important prognostic factor for neurological improvement after cranioplasty.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.26-30
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• 1999

Background : The origin of P300 was still on debate nbut thought to be in the frontal, temporal or parietal lobe. As the transcranial doppler ultrasonography(TCD) gives us and opportunity to observe hemodynamic chaged dynamically and the middle cerebral artery feeds these ares of the hemisphere, we observed the change of mean flow velocity of MCA during the event related potential test(ERP) to determine the role of these structures in P300 generation. Method : Twenty normal subjects(male : 13, age : 24-29 years) performed ERP. An auditory oddball pardigm was used to elicit the ERPs. TCD examination was performed with 2-MHz probe monitoring the left MCA(Transscan, EME). After signal identification and adjustments to maximize the Doppler signal strength, the probe was mechanically locked during the monitoring. The changes of blood flow velocity of the left middle cerebral artery(MCA) induced by cognitive demands were monitored. The measurement of the meal flow velocities(MFV) of MCA were made while the subjects were prior to, during, and after ERP. We recorded the MFVs during ERP. Statistical analysis was performed using t-tests with SPSS-PC for windows release 6.0. Results : All subjects showed a relative increase in MFV of MCA during the task. The mean rise was about 3.2-4.2%(p <0.05). Although TCD does not measure absolute values of regional cerebral blood flow(rCBF) or absolute rCBF changes, changes of flow velocity can reflect relative rCBF changes. Conclusions : The generation site of P300 still remains unclear but the neocortical, thalamic and limbic region and temporal-parietal cortex have been proposed. The MCA supplies these anatomical structures. The Changes of flow veolocity of MCA during the ERP test suggest that the some part of the brain fed y the MCA activate of the temporal lobe or parietal lobes, we can deduce that some parts of brain fed by the MCA participate in the generation of P300.