• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.55-59
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• 1999

Vasoconstriction of intracerebral arteries is the leading cause of delayed cerebral infarction and mortality following aneurysmal subarachnoid hemorrhage. Transcranial Doppler studies show and increase in the flow velocities of basal cerebral arteries, which usually start around day 4 following a subarachnoid hemorrhage, and peaking by days 7 to 14. Angiographic studies confirm the presence of at least some degree of MCA vasospasm when the flow velocities are higher than 100 cm/sec. Mean velocities in the 120 to 200 cm/sec range correspond to 25 to 50% luminal narrowing. MCA and ACA vsospasm is detected with around 90% specificity. Sensitivity is 80% and 50% respectively. A 200cm/sec threshold and rapid flow velocity increase exceeding 50 cm/sec on consecutive days, has been associated with subsequent infarction. Transcranial Doppler is also used to monitor the effects of endovascular treatment of vasospasm. Flow velocities decrease following successful angioplasty or papaverine infusion. Overall, transcranial Doppler studies are considered to have acceptable accuracy for the evaluation of vasospasm in aneurysmal subarachnoid hemorrhage, with limitations that have to be taken into consideration in the clinical setting.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.60-63
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• 1999

Transcranial Doppler(TCD) is an important diagnostic tool for evaluating the patients with stroke. It has some advantages and unique role when compared with other neuroimaging modalities. Recent development of transcranial color-coded Doppler(TCD) improves the limitation and pitfalls of TCD. The current indications of TCD are as follows: 1. Screening and evaluation of the intracranial major vessels 2. early detection and follow-up of vasospasm due to SAH 3. emboli detection (high-imtensity transient signals, HITs) 4. dignosis and follow-up of subclavian steal 5. evaluation of intracranial collaterals when the extracranial ICA has severe stenosis or occlusion 6. evaluation of cerebral perfusion pressure (intracranial pressure) 7. evaluation of arteriovenous malformation 8. diagnosis and follow-up of arterial dissenction 9. diagnosis and follow-up of venous sinus thrombosis (experimental).

• 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).

• 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.

• Journal of Korean Physical Therapy Science
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• v.6 no.4
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• pp.153-165
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• 1999

The transcranial Doppler(TCD) is a technique for measuring blood flow velocity of intracranial and extarcranial arteries. This examination based on Doppler effect which was first formulated in 1842 by the Austrian physicist Christian Doppler. In 1982, Rune Aaslid first maked 2MHz pulsed probe and recording intracranial vessels with transcranially. There are six criteria utilized in gaining positive identification of the intracranial vessels. The six criteria are as follows l)acoustical windows 2)depth of sample volume 3)direction of flow 4)spatial relationship of ACA and MCA bifurcation 5)mean velocity and 6)response common carotid artery compression and/or oscillation test. The affected factors for TCD examination are angle of insonation, posture of subject, age, gender, hematocrit, metabolic factors, and cardiac output. Clinical application of TCD are detection of stenosis, occlusion, emboli, thrombsis in intracranial and extracranial arteries and evaluation of cerebral arterovenous malformation, collateral capacity in the circle of Willis, ischemia cerebrovascular disease, stroke patient and vertebrobasilar system.

• The Journal of Internal Korean Medicine
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• v.26 no.3
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• pp.699-707
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• 2005

Vertebrobasilar insuffciency(VBI) is also refered to as vertebrobasilar transient ischemic attack(V-B TIA). Vertebrobasilar insufficiency is often undiagnosed or misdiagnosed due to complexity of the symptoms. Transcranial doppler(TCD) can be used to possible to record the blood flow velocities in the cerebral arteries through the intact cranium. Transcranial doppler and magnetic resonance angiography(MRA) are both noninvasive techniques that can be used in vertebrobasilar insufficiency, but transcranial doppler is more sensitive with respect to evaluating stenotic lesion of the arteries than magnetic resonance angiographv. Diagnostic values of transcranial doppler were assessed in patients with vertebrobasilar insufficiency. A case of vertebrobasilar insufficiency is here reported. A 62-year-old man with dizzness, nausea and tremor because of vertebrobasilar insufficiency was admitted at Wonkwang Oriental Medicine Hospital. He was treated with the herbal medicine Chunmagudung-um and with acupunture. Results showed improvement of symptoms and favorable transcranial doppler readings. The process used in this successful treatment is here described.

• 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.

• 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.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.477-483
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• 2018

Transcranial doppler is a non-invasive method that measures the blood flow velocity and the direction of cerebral blood vessels through the doppler principle. The pulsatility index is an index for measuring the transcranial doppler that reflects the distal vascular resistance and is used as an index for the presence and diffusion of cerebral small vessel diseases. The purpose of this study was to evaluate the risk factors affecting the basilar artery pulsatility index in ischemic stroke patients. From January 2014 to May 2015, 422 patients were selected by measuring the transcranial doppler pulsatility index, considering their basilar artery pulsatility index. Univariate analysis was performed using the basilar artery pulsatility index as a dependent variable. Multiple regression analysis was performed considering the factors affecting the pulsatility index as variables. Univariate analysis revealed age, presence of hypertension, presence of diabetes mellitus, presence of hyperlipidemia, and hematocrit (P<0.1) as factors. Multiple regression analysis showed statistically significant results with age (P<0.001), presence of diabetes (P=0.004), and presence of hyperlipidemia (P=0.041). The risk factors affecting the basilar artery pulsatility index of transcranial doppler were age, diabetes, and hyperlipidemia. Further research will be needed to increase the cerebral pulsatility index as a surrogate marker of the elderly, diabetes, and hyperlipidemia.

• Annals of Clinical Neurophysiology
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• v.21 no.2
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• pp.71-78
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• 2019

Transcranial Doppler (TCD) was introduced in 1982 to assess intracranial arteries noninvasively, since when it has been widely used to assess and monitor cerebrovascular hemodynamics. The clinical applications of TCD are broadening to include other fields that require monitoring of the cerebral blood flow. TCD has fewer temporal and spatial restrictions than other methods, can be performed on less-compliant patients, and causes no harm to the body. However, its reliance on high levels of examiner skill and experience, as well as a lack of standardized scanning protocols are obstacles that still need to be overcome. In this report we review TCD examination techniques and interpret their findings for several conditions.