Transcranial Doppler and Imaging

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Transcranial Doppler and Imaging
2015-03-15 22:08:01
core II
Show Answers:

  1. What does MESs stand for?
    microembolic signals
  2. What are three ways to tell if AVM?
    • 1.) increased flow velocity
    • 2.) reduced pulsatility
    • 3.) reduced responsiveness to CO2
  3. What does AVMs stand for?
    Arterial venous malformations
  4. What percent of large to medium sized AVMs can we find using TCD?
  5. What are 3 main types of monitoring use TCD?

    What is the most common?
    1.) intermittent monitoring

    2.) continuous monitoring

    3.) functional testing

    Intermittent is the most common
  6. What are 6 reasons why we might use intermittent monitoring using TCD?
    • 1.) monitoring vasospasm
    • 2.) subaraqchnoid hemorrhage
    • 3.) severe migraines
    • 4.) ICA occlusion
    • 5.) anticoagulation given
    • 6.) shrink AVM's
  7. What are 6 reasons why we might use continuous monitoring using TCD?
    • 1.) While doing a CEA
    • 2.) Cardiopulmonary bypass on heart
    • 3.) Neural surgery
    • 4.) Increase ICP or intracranial pressure
    • 5.) Diagnose brain death
    • 6.) those with severe cerebrovascular disease
  8. What are 4 reasons why we might use functional testing using TCD?
    • 1.) simulation of vasomotor
    • 2.) language lateralization
    • 3.) pre-evaluation look at the collateral flow in circle of willis
    • 4.) stimulation of visual cortex
  9. What are 2 main things we need to do before a TCD?
    1.) Do a Carotid Duplex to evaluate extracranial artery status.

    2.) Have patient resting to avoid PCO2 fluctuations.
  10. What are the 6 things we look at when doing an transcranial exam? (not specific things)
    • 1.) cranial windows
    • 2.) Insonation depth (cm)
    • 3.) Flow direction
    • 4.) Spatial relationships
    • 5.) Relative flow velocity
    • 6.) Response to oscillational compression
  11. What is oscillational compression?
    compress of CCA
  12. Which acoustic window is the thinnest?
  13. What degree of insonation do we use for TCD?

    Can use other places?
    zero degrees

    Can be 0-30 degrees
  14. When using relative flow velocities what are we using?
    Full name?
    Other name?

    Time Average Maximum Velocity

    Mean Velocity
  15. What does Dysarthia mean?
    difficulty speaking
  16. What does Dysphagia?
    Difficulty swallowing
  17. What does Dysphasia mean?
    difficulty with speech
  18. What does intracranial mean?
    within the cranium
  19. What does contralateral mean?
    relating to the opposite side
  20. What does Ipsilateral mean?
    same side
  21. What does ICP mean?
    intracranial pressure
  22. What does CEA mean?
    carotid endartectomy
  23. What does hypoplastic mean?
    small or not there in vessel system
  24. What does hypoperfusion mean?
    low blood pressure
  25. What does spontaneous rupture of aneurysms typically result in?
    How many people annually?
    How many die on the way to hospital?
    How many die in 1 to 3 months?
    What is the mortality rate?
    • SAH - Subarachnoid hemorrhage
    • 30,000 annually
    • 10-15% with ruptured die on the way to hosp.
    • 40% die in 1 to 3 months
    • 40% morality rate
  26. How many NOn-traumatic saccular aneurysms occur in the anterior circulation?

    How many in the posterior circulation?
    90% anterior circulation

    10% in the posterior circulation
  27. What are the symptoms of non ruptured aneurysms?  (2)
    Most people are asymptomatic

    Some have a severe headache
  28. What are two treatment options for cerebral aneurysms?

    What is the main treatment?
    How is it done?
    • 1.) clipping
    • 2.) coiling

    Surgical clipping

    Artery is exposed and a metal clip blocks flow to the aneurysm
  29. What is another name for coiling?
    And abbrieviation?
    Guglielmi Detachable Coiling (GDC)
  30. How does GDC work?
    Fill the aneurysm with coils and thrombus
  31. What is the frequent site for aneurysm formation and is the most common site of aneurysms associated with subarachnoid hemorrhage?
    • ACoA
    • Anterior Communicating Artery
  32. What is the second most common site for aneurysm formation?
    • PCA
    • Posterior Cerebral Artery
  33. What is the third most common site for congenital aneurysms aneurysm formation?

    Where does approximately one-fourth of all intracranial aneurysms come from?
    MCA bifurcation

    MCA bifurcation