Transcranial Doppler sonography

Stein E, Pankiewicz J, Harsch HH, Cho JK, Fuller SA, Hoffmann RG, Hawkins M, Rao S, Bandettini PA, Bloom AS (1998) Nicotine-induced limbic cortical activation in the human brain a functional MRI smdy. Am J Psychiatry 155 1009-1015 Sziraki I, Lipovac MN, Hashim A, Sershen H, Allen D, Cooper T, Czobor P, Lajtha A (2001) Differences in nicotine-induced dopamine release and nicotine pharmacokinetics between Lewis and Fischer 344 rats, Neurochem Res 26 609-617 Terborg C, Birkner T, Schack B, Witte OW (2002) Acute effects of cigarette smoking on cerebral oxygenation and hemodynamics a combined study with near-infrared spectroscopy and transcranial Doppler sonography, J Neurol Sci 205 71-75 Thompson JC, WUby G, Stough C (2002) The effects of transdermal nicotine on inspection time. Hum Psychopharmacol 17 157-161... 

The cause of cocaine-related stroke and transient ischemic attacks has been studied by transcranial Doppler sonography, a continuous measure of cerebral blood flow velocity, to monitor the course of cerebral hemodynamic changes during acute intravenous injection of placebo, and of cocaine 10, 25, and 50 mg in seven cocaine abusers (150). There was a significant increase in mean and systolic velocity (lasting about 2 minutes) with all doses of cocaine but not with placebo. Cocaine produced an immediate brief period of vasoconstriction... 

Shiogai T, Koshimura M, Murata Y et al. (2003). Acetazolamide vasoreactivity evaluated by transcranial harmonic perfusion imaging relationship with transcranial Doppler sonography and dynamic CT. Acta Neurochirurgia Supplement 86 57-62 Stam J (2005). Thrombosis of the cerebral veins and sinuses. New England Journal of Medicine 352 1791-1798... 

Despite the fact that transcranial Doppler sonography, like positron emission tomography, has increased our knowledge of the cerebral circulation in health and disease, and even though it is inexpensive and quite widely available and repeatable on demand (unlike positron emission tomography), it stiU has rather a minor role in routine clinical management. 

A less-invasive alternative is to inject air bubbles or other echocontrast material intravenously if there is a patent foramen ovale, they can be detected by transcranial Doppler sonography of the middle cerebral artery, particularly with a provocative Valsalva maneuver. There is considerable variation in the methods used to detect patent foramen ovale and this influences the diagnostic sensitivity and specificity. It is also uncertain what size of shunt is "clinically relevant" and some bubbles may pass to the brain through pulmonary rather than cardiac shunts (Droste ef al. 1999, 2002 Schwarze ef al. 1999),... 

The methods described below in human marijuana users and respective nonmarijuana users outline (1) neuropsychological assessment of marijuana users, (2) transcranial doppler sonography, and (3) EEG recordings and analysis. 

Arnolds, B. J. and von Reutem, G. M. (1986) Transcranial Doppler sonography examination technique and normal reference values. Ultrasound Med. Biol. 12, 115-123. 

Larsen, F.S., Pott, R, Hansen, B.A., Ejlersen, E., Knudsen, G.M., Qemmesen, J.D., Secher, N.H. 1995b. Transcranial doppler sonography may predict brain death in patients with fulminant hepatic failure. Transpl Proc 27 (6) 3510-3511... 

Various methods have been employed to measure cerebral perfusion, including PET, SPECT (Lewis et aL 1992), xenon CT (Yonas et aL 1989), and transcranial Doppler sonography (Clyde et aL 1996). Of these modalities, sonography has been the most widely used, but has many hmitations, as it is operator dependent, cannot quantify CBF at the tissue level, and, alone, may not be specific enough to guide therapy. 

Changes in NIR spectra and transcranial Doppler sonography parameters were significantly correlated with variations of end-tidal CO2 (P <. 005). Their overall conclusion was that NIR was a viable technique for evaluation of cerebrovascular reactivity for patients with cerebrovascular disease. 

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