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Transcranial Doppler sonography follow-up study in mild vascular cognitive impairment.

PLoS One

January 2025

Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy.

Background: To date, few data to transcranial Doppler sonography (TCD) are available in patients with mild vascular cognitive impairment (VCI) at risk for vascular or mixed dementia. In a previous study in patients with mild VCI and cerebral small vessels disease, a hemodynamic pattern of cerebral hypoperfusion and enhanced vascular resistance were observed; however, longitudinal data are currently lacking. Here, we perform a clinical, psychopathological, and neurosonological follow-up of patients with VCI in order to monitor any progression and to identify TCD measures to detect it.

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Acute internal carotid artery occlusion (AICAO) can result in malignant cerebral edema and unfavorable patient outcomes. This study evaluated the utility of transcranial Doppler (TCD) in assessing contralateral flow compensation and predicting outcomes in patients with AICAO. We enrolled 51 patients within 6 h of symptom onset and conducted TCD examinations to evaluate collateral circulation.

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Mean middle cerebral artery velocity (MCAv) and the pulsatility index (PI), at rest and in response to exercise, are important markers of cerebrovascular health status in middle-aged adults, when vascular decline assumes substantial relevance. Thus, this study aimed to describe and compare the responses of MCAv and PI to incremental exercise. Two hundred and forty-eight volunteers (50-58 years, 55% women) completed a ramp test on a cycle-ergometer.

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Article Synopsis
  • The study investigates the significance of the pulsatility index (PI) from transcranial Doppler (TCD) in predicting delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) despite its lack of endorsement in current guidelines.
  • Elevated arterial pressure gradient (ΔP) calculated from PI showed a significant association with DCI, while mean cerebral blood flow velocity (mCBFV) was linked to vasospasm but not DCI.
  • The findings suggest that TCD-estimated ΔP could be a valuable predictor for DCI in SAH patients, highlighting its potential impact on long-term functional outcomes.
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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.

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