• Annals of Clinical Neurophysiology
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• 제14권1호
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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.

• 대한임상검사과학회지
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• 제55권3호
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• pp.219-226
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• 2023

뇌혈류초음파(TCD) 검사는 일반적으로 2 MHz의 낮은 주파수를 이용해서 두개강 내의 혈류속도 및 파형을 측정하는 검사이다. 많은 병원에서 병리사들이 검사를 시행하고 있고 학교, 뿐만 아니라 학회차원에서 교육들도 이루어지고 있다. 하지만 TCD검사는 검사자의 스킬이 무엇보다 중요한 검사 중에 하나다. 처음으로 검사를 접하는 검사자들은 혈관이 잘 찾아지지 않아 고민이 생기고, 어느 정도 경험한 검사자들은 혈관이 너무 많이 찾아져서 고민이 된다고 한다. 직접 혈관을 보고 측정하는 검사가 아니기 때문에 많은 제한과 어려움이 있을 수밖에 없다. 그래서 TCD 검사자들을 위해서 검사를 시행할 때 주의사항과 노하우를 소개함으로써 도움을 드리고자 한다.

• Annals of Clinical Neurophysiology
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• 제1권1호
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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.

• 동의신경정신과학회지
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• 제15권2호
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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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• 제49권1호
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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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• 제20권2호
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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.

• 대한한방내과학회지
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• 제29권4호
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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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• 제18권6호
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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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• 제40권6호
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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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• 제1권1호
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• pp.26-30
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• 1999

본 연구에서는 ERP검사 중에는 중뇌동맥의 MFV가 검사전후와 비교하여 유의하게 증가힌 소견을 보였다. 비록 중뇌동맥의 혈류속도의 변화가 뇌활동정도를 직접 반영할 수는 없다고 생각이 되지만 이 연구의 결과로 P300의 생성에 중뇌동맥에 의해서 영양받는 전두엽, 측두엽 및 두정엽이나 다른 대뇌부위가 관여할 것으로 사료된다. 경두개도플러검사는 다른 뇌기능활동을 반영할 수 있는 양전자방출단층촬영이나 단일광자방출단층촬영과 같이 혈류역학을 볼 수 있는 검사와 병행하여 연구하면 P300의 발생부위를 규명하는데 도움을 줄 것으로 사료되며 뇌활동을 역동적으로 평가하는데 도움을 줄 것으로 생각된다.