Original contribution
Transcranial measurement of blood velocities in the basal cerebral arteries using pulsed Doppler ultrasound: A method of assessing the circle of willis

https://doi.org/10.1016/0301-5629(86)90138-9Get rights and content

Abstract

Transcranial pulsed Doppler ultrasound and spectral analysis were used for detection of blood velocities in the basal cerebral arteries. The Doppler transducer was placed superior to the zygomatic arch and during insonation of the middle cerebral artery care was taken to obtain maximum Doppler-shift frequency signals since this allowed a small angle between the ultrasound beam and this artery.

Doppler signals were obtained from the middle, anterior, and posterior cerebral arteries in 20 volunteers with the average depth of the Doppler gate at 4.9 (4.6–5.2 cm), 5.2 (4.9–5.4 cm), and 6.3 cm (6.0–6.9 cm), respectively. These measurements were in agreement with those obtained for 15 cadaver studies, in whom the distance from the proposed site of the Doppler transducer to each basal cerebral artery was measured as 4.7 ± 0.6, 5.3 ± 0.5, and 5.9 ± 0.9 cm, respectively. The reproducibility of middle cerebral artery blood velocity values was tested in seven subjects and showed a variation of not more than 8% in any individual.

The method was used in combination with common carotid compression to assess four patients who had occlusive extracranial carotid disease; in three the disease was more severe on one side and reversal of blood flow in the proximal ipsilateral anterior cerebral artery was demonstrated, consistent with cross flow from the contralateral side via the anterior communicating artery of the Circle of Willis. In the fourth patient augmentation of posterior cerebral artery blood velocities during common carotid compression indicated the major collateral source was from the vertebrobasilar system.

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    Diastolic velocity decreases and pulsatility index (systolic velocity-diastolic velocity/mean velocity) increases.31 Transcranial Doppler does not give direct information about changes in cerebral blood flow, but a compromised flow velocity pattern as evidenced by an increase in the pulsatility index can be a sensitive index of impending ischemic injury.27 The pulsatility index has been used in the diagnosis of blocked shunts in children.

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Department of Radiological Sciences.

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Department of Anatomy.

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