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Transcranial Doppler (TCD/TCCS) and Cerebral Blood Flow Velocities: Parameters of Normality

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Neurosonology in Critical Care

Abstract

Normal values in transcranial Doppler (TCD/TCCS) evaluation have been defined since the description of the technique, and each laboratory has its own reference values for its population; differences are small in general, but current recommendation is that every cerebrovascular laboratory should develop its own table for reference values. We present a review of several reference values developed throughout the world since the seminal work of Aaslid, including our local table for velocities, pulsatility index and depth of the main intracranial arteries.

We explain our method in order to guide other groups to develop local reference values for their population.

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References

  1. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg. 1982;57(6):769–74.

    Article  CAS  Google Scholar 

  2. Bishop CC, Powell S, Rutt D, Browse NL. Transcranial Doppler measurement of middle cerebral artery blood flow velocity: a validation study. Stroke. 1986;17(5):913–5.

    Article  CAS  Google Scholar 

  3. Lindegaard KF, Nornes H, Bakke SJ, Sorteberg W, Nakstad P. Cerebral vasospasm after subarachnoid haemorrhage investigated by means of transcranial Doppler ultrasound. Acta Neurochir Suppl (Wien). 1988;42:81–4.

    CAS  Google Scholar 

  4. Maeda H, Etani H, Handa N, Tagaya M, Oku N, Kim BH, et al. A validation study on the reproducibility of transcranial Doppler velocimetry. Ultrasound Med Biol. 1990;16(1):9–14.

    Article  CAS  Google Scholar 

  5. Puppo Vallini BC. Doppler transcraneano en el paciente neurocrítico. Paciente crit (Uruguay). 2001:52–68.

    Google Scholar 

  6. Baumgartner I, Behrendt P, Rohner P, Baumgartner RW. A validation study on the intraobserver and interobserver reproducibility of renal artery duplex ultrasound. Ultrasound Med Biol. 1999;25(2):225–31.

    Article  CAS  Google Scholar 

  7. Arnolds BJ, von Reutern GM. Transcranial Doppler sonography. Examination technique and normal reference values. Ultrasound Med Biol. 1986;12(2):115–23.

    Article  CAS  Google Scholar 

  8. Hennerici M, Rautenberg W, Sitzer G, Schwartz A. Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity--part 1. Examination technique and normal values. Surg Neurol. 1987;27(5):439–48.

    Article  CAS  Google Scholar 

  9. Sorteberg W, Langmoen IA, Lindegaard KF, Nornes H. Side-to-side differences and day-to-day variations of transcranial Doppler parameters in normal subjects. J Ultrasound Med. 1990;9(7):403–9.

    Article  CAS  Google Scholar 

  10. Vriens EM, Kraaier V, Musbach M, Wieneke GH, van Huffelen AC. Transcranial pulsed Doppler measurements of blood velocity in the middle cerebral artery: reference values at rest and during hyperventilation in healthy volunteers in relation to age and sex. Ultrasound Med Biol. 1989;15(1):1–8.

    Article  CAS  Google Scholar 

  11. Schmidt EA, Piechnik SK, Smielewski P, Raabe A, Matta BF, Czosnyka M. Symmetry of cerebral hemodynamic indices derived from bilateral transcranial Doppler. J Neuroimaging. 2003;13(3):248–54.

    Article  Google Scholar 

  12. Droste DW, Ludemann P, Anders F, Kemeny V, Thomas M, Krauss JK, et al. Middle cerebral artery blood flow velocity, end-tidal pCO2 and blood pressure in patients with obstructive sleep apnea and in healthy subjects during continuous positive airway pressure breathing. Neurol Res. 1999;21(8):737–41.

    Article  Google Scholar 

  13. Macchi C, Catini C. The measurement of the calibers and blood-flow velocities of the arteries of the circle of Willis: a statistical investigation of 120 living subjects using transcranial color-Doppler ultrasonography. Ital J Anat Embryol. 1994;99(1):9–16.

    CAS  PubMed  Google Scholar 

  14. Krejza J, Mariak Z, Walecki J, Szydlik P, Lewko J, Ustymowicz A. Transcranial color Doppler sonography of basal cerebral arteries in 182 healthy subjects: age and sex variability and normal reference values for blood flow parameters. AJR Am J Roentgenol. 1999;172(1):213–8.

    Article  CAS  Google Scholar 

  15. Tegeler CH, Crutchfield K, Katsnelson M, Kim J, Tang R, Passmore Griffin L, et al. Transcranial Doppler velocities in a large, healthy population. J Neuroimaging. 2013;23(3):466–72.

    Article  Google Scholar 

  16. Grolimund P, Seiler RW. Age dependence of the flow velocity in the basal cerebral arteries--a transcranial Doppler ultrasound study. Ultrasound Med Biol. 1988;14(3):191–8.

    Article  CAS  Google Scholar 

  17. Yang D, Cabral D, Gaspard EN, Lipton RB, Rundek T, Derby CA. Cerebral hemodynamics in the elderly: a transcranial Doppler study in the Einstein aging study Cohort. J Ultrasound Med. 2016;35(9):1907–14.

    Article  Google Scholar 

  18. Brouwers PJ, Vriens EM, Musbach M, Wieneke GH, van Huffelen AC. Transcranial pulsed Doppler measurements of blood flow velocity in the middle cerebral artery: reference values at rest and during hyperventilation in healthy children and adolescents in relation to age and sex. Ultrasound Med Biol. 1990;16(1):1–8.

    Article  CAS  Google Scholar 

  19. Ringelstein EB, Kahlscheuer B, Niggemeyer E, Otis SM. Transcranial Doppler sonography: anatomical landmarks and normal velocity values. Ultrasound Med Biol. 1990;16(8):745–61.

    Article  CAS  Google Scholar 

  20. Barbosa MF, Abdala N, Carrete H Jr, Nogueira RG, Nalli DR, Fonseca JR, et al. Reference values for measures of blood flow velocities and impedance indexes in healthy individuals through conventional transcranial Doppler. Arq Neuropsiquiatr. 2006;64(3B):829–38.

    Article  Google Scholar 

  21. Demirkaya S, Uluc K, Bek S, Vural O. Normal blood flow velocities of basal cerebral arteries decrease with advancing age: a transcranial Doppler sonography study. Tohoku J Exp Med. 2008;214(2):145–9.

    Article  Google Scholar 

  22. Donnelly J, Budohoski KP, Smielewski P, Czosnyka M. Regulation of the cerebral circulation: bedside assessment and clinical implications. Crit Care. 2016;20(1):129.

    Article  Google Scholar 

  23. Farhoudi M, Kermani S, Sadeghi-Bazargani H. Relatively higher norms of blood flow velocity of major intracranial arteries in North-West Iran. BMC Res Notes. 2010;3:174.

    Article  CAS  Google Scholar 

  24. Franco M, Ariza-Araújo Y, Mejía-Mantilla JH. Estimación de valores hemodinámicos mediante el uso del doppler transcraneal en un grupo de voluntarios habitantes de Cali (Colombia), una ciudad a 995 m sobre el nivel del mar. Imagen Diagnóstica. 2015;6(2):49–56.

    Article  Google Scholar 

  25. Moller K, Paulson OB, Hornbein TF, Colier WN, Paulson AS, Roach RC, et al. Unchanged cerebral blood flow and oxidative metabolism after acclimatization to high altitude. J Cereb Blood Flow Metab. 2002;22:118–26.

    Article  Google Scholar 

  26. Brass LM, Pavlakis SG, DeVivo D, Piomelli S, Mohr JP. Transcranial Doppler measurements of the middle cerebral artery effect of hematocrit. Stroke. 1988;19:1466–9.

    Article  CAS  Google Scholar 

  27. Scherle Matamoros CE, Rivero RD. Transcranial Doppler ultrasound measurements of cerebral hemodynamic parameters in healthy volunteers at 2850 meters altitude. Radiology. 2019;61(5):405–11.

    CAS  PubMed  Google Scholar 

  28. Isikay CT, Uzuner N, Gücüyener D, Ozdemir G. The effects of hematocrit and age on transcranial Doppler measurements in patients with recent ischemic stroke. Neurol India. 2005;53:51–4.

    Article  Google Scholar 

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Correspondence to Jorge H. Mejía Mantilla .

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Mejía Mantilla, J.H., Amaya, P.F., Villarreal, L.G. (2022). Transcranial Doppler (TCD/TCCS) and Cerebral Blood Flow Velocities: Parameters of Normality. In: Rodríguez, C.N., et al. Neurosonology in Critical Care . Springer, Cham. https://doi.org/10.1007/978-3-030-81419-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-81419-9_9

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