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Neurosurgical Applications of Transcranial Doppler Sonography (Paperback)
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Neurosurgical Applications of Transcranial Doppler Sonography (Paperback)
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In 1981, the Norwegian physiologist and cyberneticist, Rune Aaslid,
developed a device which made it possible to apply the transcranial
Doppler sonographic technique in man. In 1983, Dr. Albrecht Harders
took on the project of working out a clinically practicable method
that would allow atraumatic measurements to be made of the blood
flow velocity in the large branches ofthe circle of Willis. The
technique has now become a competitor of the conventional methods
of measuring the intracranial hemodynamics, including angiography
and the xenon method of cerebral blood flow measurement. Harders
proceeded from the assumption that the measurement of the blood
flow velocity is more relevant for clinical diagnoses than the
usual volume flow measurements. He stresses the very valuable
application of the technique in detecting cerebral vasospasm before
and after aneurysm surgery. The changes in the blood flow
velocities measured by transcranial Doppler sonography in the
individual vessel segments of the circle of Willis are interpreted
with respect to the various factors that can effect such changes
(collateral circulation in the circle of Willis, diameter of the
vessel, vascular resistance, the general cardiovascular situation,
arterial partial CO pressure, autoregulatory factors, position of
body). The rate of 2 complications associated with angiography has
thus been reduced, since the best time both for angiography and for
surgery can be determined, and continuous TCD examinations show
when the patient is out of a critical phase of cerebral vasospasm.
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