Transcranial Doppler detection of microembolic signals has been described in several clinical conditions such as carotid stenosis, prosthetic heart valves, acute stroke, and carotid surgery. The importance of these events for clinical decision-making is still a matter of debate. The authors review the literature and report their personal experience on the clinical significance of microemboli detection.
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http://dx.doi.org/10.1007/s100720050025 | DOI Listing |
BMC Anesthesiol
January 2025
Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University Hospitals, Tanta, Gharbya, Egypt.
Background: Although surviving sepsis campaign (SSC) guidelines are the standard for sepsis and septic shock management, outcomes are still unfavourable. Given that perfusion pressure in sepsis is heterogeneous among patients and within the same patient; we evaluated the impact of individualized hemodynamic management via the transcranial Doppler (TCD) pulsatility index (PI) on mortality and outcomes among sepsis-induced encephalopathy (SIE) patients.
Methods: In this prospective, single-center randomized controlled study, 112 patients with SIE were randomly assigned.
Alzheimers Dement
December 2024
University of Southern California, Los Angeles, CA, USA.
Background: Cerebrovascular reactivity (CVR) is a marker of cerebrovascular function defined by blood flow changes in response to vasoactive stimuli, which may represent a valuable indicator of risk for vascular brain injury and cognitive decline. Understanding of sex specific CVR patterns is limited, yet likely important for understanding vascular risk. Previous research on sex differences in CVR is mixed, and has predominantly focused on younger adults and utilized Transcranial Doppler ultrasound approaches that focus on large intracranial artery flow.
View Article and Find Full Text PDFSci Rep
December 2024
Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, 27599, USA.
A long-standing goal of neuroimaging is the non-invasive volumetric assessment of whole brain function and structure at high spatial and temporal resolutions. Functional ultrasound (fUS) and ultrasound localization microscopy (ULM) are rapidly emerging techniques that promise to bring advanced brain imaging and therapy to the clinic with the safety and low-cost advantages associated with ultrasound. fUS has been used to study cerebral hemodynamics at high temporal resolutions while ULM has been used to study cerebral microvascular structure at high spatial resolutions.
View Article and Find Full Text PDFJ Neural Eng
January 2025
University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, CANADA.
The current paper describes the creation of a simultaneous trimodal neuroimaging protocol. The authors detail their methodological design for a subsequent large-scale study, demonstrate the ability to obtain the expected physiologically induced responses across cerebrovascular domains, and describe the pitfalls experienced when developing this approach. Approach: Electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and transcranial Doppler ultrasound (TCD) were combined to provide an assessment of neuronal activity, microvascular oxygenation, and upstream artery velocity, respectively.
View Article and Find Full Text PDFMethodist Debakey Cardiovasc J
December 2024
Houston Methodist Hospital, Houston, Texas, US.
Transcarotid artery revascularization (TCAR) is a novel method to treat severe stenosis of the carotid artery with minimal embolization. During TCAR, flow reversal system redirects blood from the internal, external, and common carotid arteries into the femoral vein through a filter system to prevent debris and microparticles from entering the cerebral circulation. Transcranial Doppler (TCD) monitoring allows real-time detection of blood flow in the cerebral arteries during the operation and informs the surgeon of flow changes or possible emboli.
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