In a period of three years about seven hundred and fifty patients with steno-occlusive internal carotid artery (ICA) disease and intracranial vascular malformations have been studied using TCI technique. In extracranial ICA stenosis the most important data has been the loss of vasogenic reserve and blood flow velocity reduction about of 30-40% in homolateral middle cerebral artery (MCA) of occluded ICA. Thus in patients with cerebral ischemia, anterior cerebral artery (ACA) agenesia, abnormal course of posterior communicating artery (PcoA), MCA aneurysm and one frontal arterio- venous malformation (AVM), MCA stenosis have been documented. While TCD is commonly used for easily monitoring the patients with embolic ICA disease during surgery of heart, carotid tromboendoarterectomy and for the diagnosis of brain death, TCI allows better characterization of the basal intracranial arteries, visualization of AVMs, tumors and hematomas, and identification of cerebral aneurysms with apparently high success rates in small series of patients. In the brain TCI demonstrates a good sensitivity to blood flow in major arteries and, in addition, the spectral Doppler blood velocity waveform can be obtained by placing an electronic cursor over the artery of interest and switching to the pulsed-wave display mode. Thus blood velocity can be measured exactly with angle correction for the direction of flow relative to the ultrasound beam to detect, for example, cerebral posthemorragic vasospasm. Thus, TCI allows, by direct view of cerebral artery, a reduction of learning time for this technique and a better and prompt diagnosis in the patients with ICA stenosis.
|Translated title of the contribution||Clinical applications of TCI|
|Number of pages||10|
|Journal||Rivista di Neurobiologia|
|Publication status||Published - 1998|
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