• Title/Summary/Keyword: transcranial Doppler (TCD)

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Application of Neurophysiological Studies in Clinical Neurology (임상신경생리 분야에서의 신경생리적 검사법의 응용)

  • Lee, Kwang-Woo;Park, Kyung-Seok
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.1-9
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    • 1999
  • Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.

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Effects of Hap-Kok(LI4) and Jok-Sam-Lee(ST36) Acupuncture on Cerebral Blood Flow in In-Young(ST9) (합곡(合谷) 및 족삼이(足三里) 혈(穴) 자침이 인영혈(人迎穴)부위의 뇌혈류에 미치는 영향)

  • Lee, Chung-Sik;Park, Bo-Ra;Seo, Jong-Hoon;Kang, Hyung-Won;Lyu, Yeoung-Su;Kim, Tae-Heon
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.1
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    • pp.143-151
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    • 2007
  • Objective : This study was performed to evaluate the effects of Hap-Kok(LI4) and Jok-Sam-Lee(ST36) acupuncture on blood flow in In-Young(ST9). Method : Monitoring of TCD was examined in each 25's healthy men and wemen in 20s before and after acupucture on both(right and left) Hap-kok(LI4) and was done on both(right and left) Jok-Sam-Lee(ST36) by different group with same condition. Mean velocity and Pulsatility index analyzed from TCD at both In-Young(ST9). Both group was acupuctured for 15-20 minutes laying at bed. Results : The results showed a significant($p{\le}0.05:$ Paired T-test) decrease in mean velocity and increase in pulsatility index at both group. Conclusion : These results suggest that acupuncture could have a specific effect on blood flow called In-Young acupoint.

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Changes of Microembolic Signals after Heart Valve Surgery (심장 판막 수술 후 미세색전의 변화)

  • 조수진;이은일;백만종;오삼세;나찬영
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.316-320
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    • 2003
  • Background: The detection of circulating microemboli by transcranial Doppler ultrasonography (TCD) has the potential to select the patients with high risk for future symptomatic brain embolism. We prospectively evaluated the positive rate and the frequency of microembolic signals (MES) before and after the heart valve surgery (HVS). Material and Method: Fifty in-patients with heart valve disease were enrolled in this study. Patients with history of previous stroke or heart valve surgery were excluded. Two unilateral TCD monitoring sessions were peformed from middle cerebral artery for 1-hour, before and after HVS. Result: Mechanical Heart valves were implanted in 28 patients, tissue valves were implanted in 10 patients, and remaining 12 patients received mitral valve repair. Positive rate of MES was significantly increased after HVS (50%), compared to that of before HVS (8%, p=0.00). There was no relation between MES after HVS and intensity of anticoagulation, cardiac rhythm, patients' age, and history of hypertension. The positive rate of MES after implantation of mechanical heart valve (71.4%) was significantly higher than those after implantation of tissue valve or mitral valve plasty (p=0.002). Conclusion: Positive rate of MES was increased significantly after the implantation of HVS. The changes of MES in those with mechanical prosthesis may be related to the increased risk or embolism after Hvs.

Case-control Study : Cerebral Blood Flow as Measured by TCD in Patients with Risk Factors for Stroke (TCD를 이용한 정상군과 중풍원인질환군의 혈류측정에 관한 비교연구)

  • Heo, Jeong-Eun;Kwon, Jung-Nam;Shin, Won-Tak;Kim, Jong-Deuk;Lee, Sang-Hee;Son, Yeoun-Hui;Kim, Young-Kyun
    • The Journal of Internal Korean Medicine
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    • v.28 no.2
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    • pp.250-261
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    • 2007
  • Objectives : The purpose of this study was to evaluate the blood flow using doppler ultrasound of the MCA, ACA, PCA, BA, ICA in the patients with risk factor for stroke. Methods : 110 patients with risk factor for stroke were selected who had hypertension, diabetes mellitus, hyperlipidemia, or heart disease, as well as 89 healthy adults who did not have any symptoms of those diseases. To evaluate the blood flow, the Vs and Vm of the MCA, ACA, PCA, BA, and ICA in the two groups were measured. Result : In normal healthy adults, subjects showed a decrease in the Vs and Vm: with advancing in age, there was a significant difference in the Vs of MCA, PCA, BA, and ICA. There was a significant difference in the Vm of MCA, PCA, BA, and ICA. In normal healthy adults, females showed high velocities in all examined vessels. There was a significant difference in the Vs of BA. There was a significant difference in the Vm of BA, and ICA. There was a decrease in the Vs, and Vm of all examined vessels of patients with risk factors for stroke in comparison with normal healthy adults. There was no significant difference in the Vs. There was a significant difference in the Vm of MCA, ACA, and PCA. Results were the same between patients aged under 50 and total patients in the Vs and Vm of examined vessels. There were differences between patients aged over 50 and total patients in the Vs of MCA, PCA, BA and for patients aged over 50; patients with risk factor for stroke who had hypertension, diabetes mellitus, hyperlipidemia, or heat disease has higher Vs than healthy adults. Conclusions : There was a significant difference in the blood flow velocity between patients with risk factors for stroke and healthy adults. However, this result was different from results of comparison of TCD findings between patients and healthy individuals by age. Therefore, more detailed studies about aged patients are needed.

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Study on Cerebral Blood Flow in In-Young(ST9) after Treatment on Chronic Daily Headache Patients (만성두통 환자에서 한방 치료 후 인영혈 부위의 뇌혈류에 대한 연구)

  • Lee, Chung-Sik;Park, Bo-Ra;Park, In-Suk;Kim, Ji-Hwon;Lee, Sang-Eon;Lim, Jin-Young;Lyu, Yeoung-Su;Kang, Hyung-Won;Kim, Tae-Heon
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.1
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    • pp.199-214
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    • 2009
  • Objectives : This study was performed to change of blood flow in In-Young(ST9) after treatment on chronic daily headache patients. Methods : Monitoring of TCD was examined in 10' s chronic daily headache patients before and after treatment. Mean velocity flow, systolic velocity and pulsatility index were analyzed from TCD at In-Young(ST9). The patients was laid for 20 minutes before treatment and also for treatment. Results : The results showed a significant(p<0.05: Paired T-test) decrease in mean velocity flow and systolic velocity. but there were no significant differences in pulsatility index. Conclusions : These results suggest that there were significant change on blood flow in In-young of chronic daily headache patients.

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The Effects of Appling Acupressure to Acupuncture Points against Headache Reduction and the Vertebral Artery Blood Flow of Tension-type Headache Patients (경혈지압치료가 긴장성 두통환자의 추골동맥 혈류속도와 통증감소에 미치는 효과)

  • Lee, Yun-Ho;Eom, Ki-Mae;Seo, Hyo-Seok;Yun, Young-Dae
    • Korean Journal of Acupuncture
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    • v.28 no.2
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    • pp.49-58
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    • 2011
  • Objectives : The purpose of this study is examining the effects of appling acupressure to acupuncture points (study group) and Interferential current therapy (ICT) to cervical region (control group) on the cerebral blood flow of 20 tension-type headache patients and the reduction of their headaches. For approaching this examination, clinical research was conducted for three weeks those two groups, each contains 10 patients. Methods : We stimulated 7 acupuncture points for headache with the acupressure (for three weeks) and applied ICT to cervical region. Also we measured VAS (visual analogue scale) and the blood flow of the vertebral arteries with TCD (transcranial doppler ultrasonography). Results : (1) When the left and right vertebral artery of study group was compared each time, significant differences were found after the 1st treatment (p<.001). Also the significant differences were found after 2, 3weeks treatment (p<.05). (2) When the Visual Analog Scale of study group were compared periodically, the significant reductions were found after the 1 week treatments (p<.05). Also the significant differences were found after 2, 3 weeks treatments (p<.001). In the case of the control group, the significant reduction were found after the 2 and 3 weeks treatments (p<.001). Conclusions : The acupressure applied to acupuncture points reduced the headache and increased the ratio of cerebral blood flow.

Changes in Posterior Cerebral Artery Blood flow Velocity Following Head rotation and body Positioning (머리회전과 측정자세에 따른 뒤대뇌동맥의 혈류속도 변화)

  • Park, Min-Chull;Kim, Jong-Soon
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.1
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    • pp.115-120
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    • 2015
  • PURPOSE: Vertebrobasilar insufficiency (VBI) should be carefully assessed in patient for whom manipulation of the cervical spine is to be undertaken. The purpose of this study was to investigate the changes in posterior cerebral artery blood flow velocity following head and body positioning by transcranial doppler ultrasonography (TCD) in healthy subjects. METHODS: Twenty two healthy female (mean age $20.77{\pm}1.30yrs.$) participants volunteered to participate in the study. None of the participants had a history of neck pain or headache within the last 6 months. To evaluate the cerebral blood flow, we measured the mean flow velocity of the posterior cerebral artery unilaterally (right side). The blood flow velocity was measured under 3 different head positions (in a neutral head position, ipsilateral head rotation and contralateral head rotation position) and 2 different body conditions (supine position and sitting position). RESULTS: The mean blood flow velocity of posterior cerebral artery was decreased in body positioning from supine to sitting (p<.05), but the decreased rate of blood flow velocity in posterior cerebral artery did not change significantly between ipsilateral head rotation and contralateral head rotation (p>.05). CONCLUSION: These result of our study show that body positioning (sitting and supine) affect the blood flow velocity in posterior cerebral artery.

Intra-operative Neurological Monitoring and Anesthesia

  • Park, Sang-Ku;Lim, Sung-Hyuk;Park, Chan-Woo;Park, Jin-Woo;Kim, Dong-Jun;Kang, Ji-Hyuk;Jee, Hyo-Geun;Kim, Gi-Bong
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.4
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    • pp.184-198
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    • 2012
  • The purpose of intra-operative neurological monitoring (INM) is to minimize surgically induced nerve damage, sensory nerves and motor neurons without affecting the operations to proceed during surgery such as evoked potentials (EP), electromyography (EMG), electroencephalography (EEG), transcranial doppler (TCD), etc. During the course of checking a patient's condition, surveillance of ambulatory patients is a very different thing to check if the test is done under general anesthesia. INM can be possible or impossible depending on the type of drugs used and their concentrations because the monitoring is performed under anesthesia. Therefore, it is emphasized on the necessity of reviewing anesthesia which influences on INM.

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The Effects of Regular Resistive Exercise on Cardiopulmonary Ability and Cerebral Blood Flow Velocity (규칙적인 저항 운동이 심폐 능력과 뇌혈류 속도에 미치는 영향)

  • Yu, Jae-Ho;Lee, Suk-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.2
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    • pp.255-264
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    • 2010
  • Purpose : The purpose of this study is to analysis effects of resistive exercise on cardiopulmonary fitness and cerebral artery blood flow velocity. Methods : Ten healthy university students had done resistive exercise without aerobic exercise over one year participated resistive exercise group and ten general university students, then were calculated oxygen consumption ($VO_2$) and respiratory exchange rate($VO_2/VCO_2$). After a week, they were measured Transcranial Doppler Ultrasonography(TCD) at moderate exercise(HRmax 50%), maximal exercise (HRmax 100%) for taking cerebral blood flow velocity. Results : In the comparison between groups, resistive exercise group showed significant higher oxygen consumption and lower respiratory exchange than controls(p<0.05). In resistive exercise group, oxygen consumption was significant negative correlation with cerebral artery pulsatory index(p<0.05). but, oxygen consumption was significant positive correlation with systolic blood flow velocity in controls(p<0.05). Conclusions : After considering all the factors, important value in resistive exercise is regular participation and help us increasing contingency response ability.

Significance of Microembolic Signals during Oxygen Inhalation in Patients with Prosthetic Mechanical Heart Valve (인공 기계 심장 판막 이식 환자에서 산소 흡입 중 미세색전 신호의 중요성)

  • 조수진;나찬영;이은일;민양기;권기한;이정주;백만종;오삼세;홍석근
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.50-55
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    • 2004
  • Background: Transcranial Doppler ultrasonography (TCD) can detect microembolic signals (MES) in the patients with a potential embolic source. Clinical significance of MES has not been demonstrated in patients with prosthetic mechanical heart valves. We studied the correlation between cerebral thromboemoblic events after the mechanical heart valve surgery (MHVS) and residual MES during TCD monitoring with 100% oxygen inhalation in patients with mechanical heart valves. Material and Method: Twenty patients with previous cerebral thromboemoblic events after MHVS and a sex- and age-matched control group (n=30) were studied. TCD monitoring was performed from unilateral middle cerebral artery. After baseline monitoring for 20 minutes, 61 of oxygen was inspired for 40 minutes. Result: The site of valve and the duration after MHVS of the patients did not differ from those of controls. During baseline monitoring, there was no significant difference in MES prevalence or counts compared to controls. During oxygen inhalation, patients showed a higher MES prevalence (55%, 27.6%, p=0.045) and a more frequent MES counts (p=0.027) compared to controls. Conclusion: TCD monitoring with oxygen inhalation may be useful to differentiate clinically significant MES in patients with mechanical heart valve.