• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.39-46
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• 1999

Transcranial doppler ultrasonography (TCD) is a new, non-invasive and easily applicable method to evaluate cerebral hemodynamics. Last 10 years, its use in Korea has been dramatically expanded, but the qualification of TCD laboratory has yet to be settled. Since duplex sonography is seldom used in Korea, we have to depend totally on TCD to evaluate cerebral hemodynamic changes. Thus, all of the available data from every detectabler cerebral arteries has to be obtained for accurate interpretation of TCD measurements. Moreover, flow direction and wave form should be concerned in addition to the flow velocity. In this article, I present technique to measure the anterior, meddle and posterior cerebral arteries, the internal carotid artery siphon and at cervical level, and the vertebral and the basilar artery, and normal values for these measurements which is essential for the adequate interpretation.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.171-189
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• 1996

Background and Purpose: The greater part of patients to visit Hospital of Oriental Medicine suffer from cerebrovascular accident(CVA). There is transcranial Doppler(TCD) in the diagnostic method to confirm cerebrovascular accident(CVA). Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels and have been generally used to prevent symptomatic vasospasm and confirm cerebral infarction. So we studied, in the crebrovascular accident(CVA), to estimate whether transcranial Doppler(TCD) is useful to. Methods: Using transcranial doppler(Multigon Model 500M Transcranial Doppler System), we measured the mean and peak velocity and the direction of blood flow in 10 cerebrovascular accident(CVA)'s subjects who had been examined by Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). Results : As an anticipation, in cerebrovascular accident(CVA)'s subject with Cb-infarction, the mean and peak velocity of blood flow fell down remarkably and the direction of blood flow was change or irritable. But didn't find out any signal in lacunar infarction. Also, in case with spontaneous hemorrhage, the velocity and direction of blood flow was change but this signal was short of diagnosis for Cb-hemorrhage. Besides, we found signals about embolism, stenosis, thrombosis and occlusion in cerebrovascular accident(CVA)'s subjects. Conclusion: In Cb-infarction, the result of TCD was equal to diagnosis with Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). But about lacunar infarction or spontaneous hemorrhage, signals of TCD couldn't be found out or was insufficient more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). In cerebrovascular accident(CVA)'s subject with embolism, stenosis, thrombosis or occlusion, signals of TCD were found out more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). Therefore transcranial doppler(TCD) is necessary method which makes a diagnosis of cerebrovascular accident(CVA), with Computed Tomography(CT) or Magnetic Resonance Imaging(MRI).

• The Journal of the Society of Stroke on Korean Medicine
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• v.6 no.1
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• pp.45-53
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• 2005

Objective : This study was performed to examine the relationship between cerebral blood vessel with meridian by using Transcranial Doppler Ultrasonography(TCD) Method : Monitoring of TCD was examined in 10 healthy people in their twenties (mean age was 26.5±1.00). Each examination was performed before & after acupuncture. Three Meridian were tested. Those were Stomach Meridian, Bladder Meridian & Gallbladder Meridian. Maximum velocity and Mean velocity were analyzed from TCD on different vessel. Result : The results showed significant(p<0.05; Wilcoxon signed rank test) change in some cerebral blood flow after acupuncture. Conclusion : There was the relationship between Meridian and cerebral blood vessel.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.31-35
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• 1999

Dignosis of migraine is only based on the medical history, and objective methods to aid the clinical diagnosisare absent. Although transcranial Doppler ultrasonography (TCD) abnormalities in headache-free migraineurs have been reported previously, diagnostic criteria for migraine is still lacking and this may limit the practical application of TCD for migraine. We prospectively studied several abnormal TCD indices in interictal migraineurs and their sensitivity and specificity to define the optimal diagnostic criteria. Young (20 yrs$age=29.0{\pm}6.1yrs$) were compared to 69 controls (M:F=25:44, Mean $age=31.2{\pm}5.5yrs$). Elevated MFV (> 2SD)was observed in 63% of migraineurs while n 12% of control (p<0.01). High AI (>25%) or high HI (>3.0) was present in 17% of migraineurs, while 3% and none in controls (p<0.01). Sensitivity of elevated MFV, high AI, and high HI was 63%, 17%, 17% and specificity was 88%, 97%, 100%, respectively. If all these indices were combined, sensitivity and specificity reached 69% and 86%. These preliminary results suggest pathophysiological implication of vasospasm in interictal migraineurs, and TCD may be practically applicable for migraine. Optimal diagnostic criteria and therapeutic options for patients with abnormal TCD findings remain to bo determined.

• Journal of Korean Neurosurgical Society
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• v.44 no.2
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• pp.63-66
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• 2008

Objective : The purpose of this study is to investigate the correlation between various transcranial Doppler (TCD) ultrasonography parameters and clinical vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Methods : This study enrolled 40 patients presented with aneurysmal SAH between September 2006 and August 2007. We measured differences of mean blood flow velocity (BFVm), highest systolic blood flow velocity (BFVh), and Lindegaard ratio (LR) in the middle cerebral artery on TCD examination. These parameters were evaluated for correlation with clinical vasospasm by univariate analysis and the receiver operating characteristic analysis. Results : Twelve patients (30%) developed clinical vasospasm. The best TCD parameters for the detection of clinical vasospasm were revealed to be differences of BFVm, BFVh, and LR values between $1^{st}$ TCD test and $3^{rd}$ TCD (7 cm/s. 11.5 cm/s, 0.45 respectively). The positive predictive value of anyone of three parameters was 60% and the negative predictive value was 100%. Conclusion : TCD is still considered a useful tool for screening clinical vasospasm. To confirm the predictive value of the above parameters. further prospective study will be needed.

• Korean Journal of Clinical Laboratory Science
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• v.42 no.3
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• pp.155-160
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• 2010

Transcranial Doppler ultrasonography (TCD) allows measurement of blood flow velocity to be made from the basal intracerebral vessels. Blood flow velocity in TCD is highly affected not only by blood vessel diameter, blood flow volume, blood viscosity, but also age and sex. Therefore, the study is focused on the correlation between TCD measurement index and sex/age. Subjects were 214 (male 147, famale 67) who had TCD for headache and stroke evaluations at Dongguk University Ilsan Hospital neurology department from December 2009 to April 2010. Sex did not show significant differences with mean flow velocity (MFV), peak systolic flow velocity (PSFV), end diastolic flow velocity (EDFV), pulsatility index (PI) and resistance index (RI) in middle cerebral artery (MCA). Although age also did not show significant differences with MFV and PSFV, EDFV has statistically decreased with age, and PI and RI has statistically increased with age. In addition, age showed significant correlation with MFV, EDFV, PI and RI, but not with PSFV. Therefore, TCD is definitely correlated with age and sex, so that those influencial factors must be considered when being tested.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.709-716
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• 2007

Objective : We present reference values of flow velocities of intracranial and extracranial cerebral arteries and relation with change factor. Method : We checked transcranial Doppler ultrasonography on mean velocity, systolic velocity, pulsatility index, and resistance index of 252 patients. We also compared differences of change factor. Result : The result showed a difference by sex and age and relevance between vessels besides mean velocity of vessels related with past history and social history. Conclusion : According to the above results, females showed higher velocity of all vessels. With advancing age, subjects showed reduction in velocity and increase in pulsatility index and resistance index. Anterior cerebral, middle cerebral, and posterior cerebral artery increased in proportion to velocity of internal carotid artery and basilar artery. Vessel velocity correlated with diabetes mellitus, hypertension and hyperlipidemia.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.76-79
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• 1999

The most significant factor in pathogenesis of vascular headaches like migraine and cluster headache is dynamic changes of diameters of the cerebral arteries. TCD is a valuable noninvasive tool to assess the cerebral hemodynamic status by measuring the flow velocities of the intracranial cerebral arteries around the circle of Willis. TCD can evaluate flow velocities and vasoreactivity of the patients with a vascular headache during the ictal phase as well as during intericatal phase. Distribution of the changes recorded differ between types of headaches and also between the major ictal symptoms. The changes suggest the presence of prolonged vasospasm interictally and more marked relaxation of the cerebral arteries. TCD can be used to monitor the long-term clinical course of patients with vascular headache by correlation the symptomatic improvement and TCD data before and after long-term pharmacological prophylactic treatments. During the ictal phases large intervention. The results may be used in selecting and evaluating the agents for abortive therapy for acute attacks. In conclusion TCD can quantitatively evaluate vascular headaches when making diagnosis and classification and can provide guidelines to choose more individualized therapeutic options for both acute and long-term treatment.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.64-69
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• 1999

Background : Syncope was defined as transient loss of consciousness and postural tone. The mechanisms of changes in cerebral hemodynamics during syncope have not been fully evaluated. Transcranial Doppler Ultrasonography can continuously monitor the changes in cerebral hemodynamics during head-up tilt (HUT). TCD could reveal the different patterns of changes in cerebral hemodynamics during syncope. Syncope without hypotension or bradycardia could be detected by TCD. We investigated the changes in cerebral blood flow velocity during HUT using TCD in 33 patients with a history of recurrent syncope or presyncope of unknown origin. Methods & Results : The positive responses were defined as presyncope or syncope with hypotension, bradycardia, or both. During HUT without isoproterenol infusion, there were a $86{\pm}23%$ drop in DV and a $41{\pm}34%$ drop in SV in 5 patients with positive reponses, and mean changes in those were less than 10% in patients with negative reponses (p=.00, p=.00). During HUT with isoproterenol infusion, TCD showed a $80{\pm}18%$ drop in diastolic velocity in 14 patients with positive reponses, and a $47{\pm}10%$ drop in that in patients with negative reponses (p=.00), however the change in systolic velocity did not differ. TCD showed three patterns during positive responses; loss of all flow, loss of end diastolic flow, and a decrease in diastolic velocity. Loss of consciousness occurred in the patients with loss of all flow or end-diastolic flow during positive reponses. Conclusions : TCD shows different patterns of changes in cerebral hemodynamics during HUT. TCD can be used to investigate the pathophysiology of neurocardiogenic syncope.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.3
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• pp.277-287
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• 2024

Transcranial Doppler (TCD) ultrasound is a crucial non-invasive tool for assessing cerebral blood flow and is widely used to diagnose and monitor cerebrovascular diseases. This paper reaffirms the importance of TCD, details examination methods and precautions, and provides a guide for practitioners. TCD evaluates the blood flow velocity to assess stenosis, occlusion, and hemodynamic changes. Distinguishing between increased blood flow volume and decreased vessel diameter based solely on velocity is challenging, necessitating a comprehensive approach to integrating clinical findings and hemodynamic changes. The reliability of TCD results depends on the skill of the examiner and requires standardized procedures and continuous training. Advances in automation and artificial intelligence promise enhanced accuracy and reliability. Future research should focus on validating and clinically applying these technologies. This paper is a review of the clinical significance of TCD, methods, and precautions, offering a valuable guide for practitioners and highlighting the potential benefits of ongoing advancements in TCD for the diagnosis and treatment of cerebrovascular diseases.