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Vascular Board > Transcranial Doppler and Misc Cerebrovascular > Flashcards

Transcranial Doppler and Misc Cerebrovascular Flashcards

1
Q

What is capable of evaluating onset, severity, and time course of vasoconstriction from subarachnoid hemorrhage?

A

transcranial Doppler

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2
Q

Transcranial Doppler is capable of assessing what?

A

Intracranial arteriovenous malformations
Assess patients with suspected brain death
Intracranial stenosis, occlusions, and assess collateral circulation

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3
Q

Limitations of transcranial Doppler?

A
  • Recent eye surgery
  • Adequate penetration of temporal bone from hyperostosis
  • Inaccurate vessel identification with nonimaging technique
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4
Q

What are three acoustic windows used for transcranial doppler?

A

transtemporal, transorbital, and transforaminal/suboccipital

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5
Q

What is required for accurate vessel identification with transcranial doppler?

A
  • Depth of sample volume
  • Velocity of blood flow
  • Direction of blood flow
  • Relationship of flow patterns to one another
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6
Q

2 MHz pulsed Doppler, zero angle of insonation is assumed, and time average max velocity (TAMV) or mean velocity are used in what?

A

transcranial doppler

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7
Q

The unilateral transtemporal approach if used for what vessels?

A

MCA, ACA, PCA, and terminal ICA

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8
Q

Ipsilateral transorbital approach to evaluate what arteries?

A

ophthalmic artery and carotid siphon

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9
Q

The intracranial vertebral and basilar arteries are evaluated with what approach?

A

transforminal/ suboccipital approach

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10
Q

What is the cross-over collateral pathway?

transcranial

A

Antegrade flow in anterior cerebral artery from contralateral ACA via anterior communicating artery

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11
Q

What is the external to internal collateral pathway?

transcranial

A

retrograde flow in opththalmic artery

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12
Q

What is the posterior to anterior collateral pathway?

transcranial

A

increased flow in posterior cerebral artery (PCA), reversing direction of flow in the PCom artery

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13
Q

Factors that may alter intracranial blood flow?

A

age, sex, hematocrit, blood gases, metabolism

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14
Q

Vasospasm transcranial?

A

-Most accurate in MCA
-Serial recordings necessary
-Mean velocities >120 cm/s
Severe vasospasm = >200cm/s

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15
Q

Indication of arteriovenous malformation in transcranial doppler?

A
  • Increased systolic and diastolic flow velocities
  • Very low pulsatility indices
  • Reduced flow in adjacent arteries
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16
Q

Subclavian occlusion results in retrograde flow in what artery?

A

ipsilateral vertebral

17
Q

What is a recommended treatment for subclavian steal?

A

bypass graft or endarerectomy

18
Q

Indications of subclavian steal?

A
  • BP difference of 15-20 mmHg
  • Decreased pulses in affected arm
  • Ipsilateral vertebral artery feeding high-resistance vascular bed
  • Patient usually asymptomatic, arm claudication is rare
19
Q

Inflammation of the arterial wall of the superficial temporal artery or its frontal and/or parietal branches?

A

temporal arteritis

20
Q

Characteristics of temporal arteritis?

A
  • Inflammed arterial segments usually larger in diameter with homogeneous thickening evident on B-mode
  • An anechoic halo from edema of the intima may be seen
  • Intimal thickening may result in hemodynamically significant stenosis where PSV’s are doubled
21
Q

An arteriography can be usesd to detect abnormalities such as?

A

filling defect, absent vessel, aberrant anatomy

22
Q

Equation for calculating diameter reduction longitudinally?

A

DR=(1-d/D) x 100

23
Q

Equation used to calculate diameter reduction in trans?

A

a=d^2

24
Q

What test is extremely sensitive in detecting the presence of stenosis but tends to overestimate the disease process?

A

MR angiography

25
Q

What test is most frequently used to evaluate cerebrovascular disease?

A

CT

26
Q

For a stenosis what surgical treatment is done to remove atherosclerotic material?

A

endarerectomy

27
Q

When there is an occlusion, what surgical intervention is done?

A

usually none

28
Q

What is designed to maintain the intraluminal structure and patency of the artery and acts as a type of scaffold?

A

a stent

may expect some flow acceleration post-stenting

Vascular Board (21 decks)

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