Abstract
Using noninvasive transcranial Doppler sonography, we studied cerebral collateral patterns in 30 patients with stenosis and/or occlusion of the extracranial internal carotid artery (ICA). All patients with unilateral ICA stenosis ⩽ 80% had normal transcranial Doppler findings. 80% of patients with unilateral and 50% of patients with bilateral ICA stenosis of more than 80% including those with occlusion showed a collateralization via the ipsilateral anterior and/or posterior cerebral artery. 20% of patients with unilateral and 50% of patients with bilateral ICA stenoses of more than 80% (including occlusion) had two or three collateral pathways, including the ophthalmic artery.
Another ten patients with stenosis or spasm of the middle cerebral artery (MCA) showed increased flow velocities with turbulence in the narrow segment. In four patients with severe MCA disease with a systolic peak velocity of more than 200 cm/s, the Doppler waveform distal to the lesion was damped.
Decreased regional cerebral blood flow (rCBF) measured by99mTc-HMPAO-SPECT was found in two patients with severe MCA stenosis. Another patient with moderate MCA stenosis with a systolic peak velocity of 140 cm/s showed a normal cerebral perfusion pattern.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aaslid R, TM Markwalder, H Nornes: Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 57 (1982) 769–774
Aaslid R, P Huber, H Nornes: Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. J Neurosurg 60 (1984) 37–41
Aaslid R, KF Lindegaard: Cerebral hemodynamics. In:Aaslid R (ed): Transcranial Doppler Sonography. Springer Verlag, Wien-New York 1986
Aaslid R: Zukünftige Möglichkeiten der transkraniellen Doppler-Sonographie. In:Widder B (ed): Transkranielle Doppler-Sonographie bei zerebrovaskulären Erkrankungen. Springer Verlag, Berlin-Heidelberg-New York-London-Paris-Tokyo 1987
Gosling RG, DH King: Arterial assessment by Doppler-shift ultrasound. Proc R See Med 67 (1974) 447–449
Harders A, J Gilsbach: Transkranielle DopplerSonographie in der Neurochirurgie. Ultraschall 5 (1984) 237–245
Lindegaard KF, SJ Bakke, P Grolimund, R Aaslid, P Huber, H Nornes: Assessment of intracranial hemodynamics in carotid artery disease by transcranial Doppler ultrasound. J Neurosurg 63 (1985) 890–898
Mattle H, P Grolimund, P Huber, M Sturzenegger, HRZurbrügg: Transcranial Doppler Sonographic findings in middle cerebral artery disease. Arch Neurol 45 (1988) 289–295
Niederkorn K, LG Myers, CL Nunn, MR Ball, WM McKinney: Three-dimensional transcranial Doppler blood flow mapping in patients with cerebrovascular disorders. Stroke 19 (1988) 1335–1344
Padayachee TS, FJ Kirkham, RR Lewis, J Gillard, MCE Hutchinson, RG Gosling: Transcranial measurement of blood velocities in the basal cerebral arteries using pulsed Doppler ultrasound: a method of assessing the circle of Willis. Ultrasound in Med & Biol 12 (1986) 5–14
Ringelstein EB, H Zeumer, G Korbmacher, F Wulfinghoff: Transcranielle Doppler-Sonographie der hirnversorgenden Arterien: Atraurnatische Diagnostik von Stenosen und Verschlüssen des Carotissyphons und der A. cerebri media. Nervenarzt 56 (1985) 296–306
Rossman, S Duren, S Otis: Duplex scanning with continuous wave Doppler for carotid disease. J Clin Ultrasound 13 (1985) 325–328
Schneider PA, EB Ringelstein, ME Rossman, RB Dilley, DF Sobel, SM Otis, EF Bernstein: Importance of cerebral collateral pathways during carotid endarterectomy. Stroke 19 (1988) 1328–1334
Schneider PA, ME Rossman, S Torem, SM Otis, RB Dilley, EF Bernstein: Transcranial Doppler in the management of extracranial cerebrovascular disease: implications in diagnosis and monitoring. J Vase Surg 7 (1988) 223–231
Seiler R, P Grolimund, H Zurbrügg: Die transkranielle Doppler-Sonographie. Schweiz med Wschr 116 (1986) 626–634
Wechsler LR, AH Ropper, P Kistler: Transcranial Doppler in cerebrovascular disease. Stroke 17 (1986) 905–912
Zwicker C, H Huben, M Langer, W Fiegler: Kombinierte Anwendung von Duplex-Sonographie und CW-Doppler bei Erkrankungen der Karotiden. Röntgen-Bl 40 (1987) 311–314
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rosenkranz, K., Langer, R., Cordes, M. et al. Transcranial Doppler ultrasound in internal carotid artery and middle cerebral artery disease. Neurosurg. Rev. 15, 37–44 (1992). https://doi.org/10.1007/BF02352066
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02352066