Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries

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✓ In this report the authors describe a noninvasive transcranial method of determining the flow velocities in the basal cerebral arteries. Placement of the probe of a range-gated ultrasound Doppler instrument in the temporal area just above the zygomatic arch allowed the velocities in the middle cerebral artery (MCA) to be determined from the Doppler signals. The flow velocities in the proximal anterior (ACA) and posterior (PCA) cerebral arteries were also recorded at steady state and during test compression of the common carotid arteries. An investigation of 50 healthy subjects by this transcranial Doppler method revealed that the velocity in the MCA, ACA, and PCA was 62 ± 12, 51 ± 12, and 44 ± 11 cm/sec, respectively. This method is of particular value for the detection of vasospasm following subarachnoid hemorrhage and for evaluating the cerebral circulation in occlusive disease of the carotid and vertebral arteries.

Article Information

Address reprint requests to: Rune Aaslid, Ph.D., Neurochirurgische Klinik, Inselspital, CH-3010 Bern, Switzerland.

© AANS, except where prohibited by US copyright law.

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Figures

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    Upper: Spectral display of the Doppler signal from the middle cerebral artery (MCA). The horizontal line through the spectra represents a cursor that can be controlled up or down on the display. Lower: The outline of the spectra shown above. The cursor was placed so that the areas A1 and A2 were judged equal. The velocity corresponding to this cursor position was calculated using the Doppler equation.

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    Diagram of the area (dotted line) where Doppler signals from intracranial arteries were obtained. The zygomatic arch is indicated. The most likely location to obtain signals is shown by the position of the probe.

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    Frontal view of the ultrasound probe directed toward the middle cerebral artery (MCA). The cylinder around the MCA indicates the observation region (sampling volume) for the Doppler recording. The distance from the middle of the cylinder to the probe corresponds to the depth setting.

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    Spectral display of the Doppler signal from the middle cerebral artery (MCA, upper) and the terminal internal carotid artery (ICA, lower) during test compressions of the common carotid artery (CCA) on the ipsilateral side in a 51-year-old man. The MCA velocity fell by 40% during compression. Note the reversed systolic flow in the terminal ICA. This indicates external carotid artery “steal.”

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    Spectral display of the Doppler signal from the proximal anterior cerebral artery (ACA) during test compression of the common carotid artery (CCA) on the ipsilateral side (upper), and on the contralateral side (lower). Arrows indicate irregular flow during systole.

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    Spectral display of the Doppler signal from the proximal part of the posterior cerebral artery (PCA) during test compression of the common carotid artery (CCA) on the ipsilateral side. Velocity increased by 60% with return to preocclusion level.

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    Diagram of the velocities in the middle cerebral artery (MCA) in 10 normal subjects (10 upper panels). The abscissae are the depth settings at which the velocity determinations were made. Notice that the depths of the left and right sides run toward the midline from each side. If more than one velocity is given at a certain depth, it indicates that determinations in two branches were made. The lower panel represents the means of the MCA velocities in 10 subjects. The standard deviations are indicated by vertical bars.

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