In addition to the aforementioned clinical uses, cranial ultrasound has been shown to have emerging roles in the evaluation of pediatric skull fracture and other cranial pathologies. Reduced acoustic view in 5-20% of patients 4 Not as accurate as current gold standard brain imagingīedside technique that is easily repeatable Provides real-time information on status of cerebral arteries Advantages and Disadvantages of TCD in the ED A comparison of the advantages and disadvantages can be seen in Table 1.
While it can be difficult to obtain a good acoustic window in 5-20% of patients, 4 TCD allows us an opportunity to diagnose and treat intracranial pathologies when other modes of brain imaging are not available. TCD has the ability to provide dynamic, real-time information on intracranial processes in a way that a single snapshot in time, as obtained by CT, cannot. Neurologic emergencies rely heavily on speed of provider recognition and appropriate escalation of care. 2,3 While TCD is at a disadvantage to CT in definitive diagnostic ability, it boasts distinct advantages that CT cannot replicate. 1 Since then, it has gained momentum as a tool to evaluate intracranial emergencies including post-aneurysmal hemorrhage, middle cerebral artery (MCA) vasospasm, cerebral ischemia/arterial occlusion, and midline shift. Transcranial Doppler (TCD) ultrasound was first utilized in 1982 as a noninvasive way to evaluate cranial blood flow, particularly of the middle, anterior, and posterior cerebral arteries (MCA, ACA, and PCA, respectively). We also believe that our technologies will help create much more effective methods to treat glaucoma than currently available methods.Transcranial Doppler offers exciting potential - but in what settings? This literature review evaluates its use in trauma, ICU, pediatric, rural, and international settings. I believe that our patented, non-invasive ICP technologies will be used as widely as non-invasive blood pressure measurement in the near future.
What does this technology mean for the future of measuring intracranial pressure? To accurately diagnose glaucoma, it is important to capture extremely high resolution small changes in the brain’s physical parameters – our technology demonstrates this, providing high resolution results for traumatic brain injuries, stroke patients, and brain tumor neurosurgery patients included in our comparative study.
TRANSCRANIAL DOPPLER DEPTHS SOFTWARE
Our software solution is able to identify – for the first time – very small intracranial pressure and intracranial compliance changes using automatic analysis of recorded pulse wave morphology. Our patented pressure balance method is the only method that does not require calibration but still produces accurate and precise ICP measurements outside of neurosurgical ICU. The value of extracranial pressure is almost equal to ICP value in a pressure balance case when blood flow velocities in both OA segments are the same. Our two depth transcranial Doppler (TCD) technology works by applying external pressure to a closed eyelid and taking simultaneous measurements of blood flow velocities in intracranial and extracranial (orbital) segments of the ophthalmic artery (OA). How does this new technology differentiate itself? Such calibration is impossible because a “gold standard” non-invasive ICP meter needed for calibration does not exist. Unfortunately, other proposed non-invasive technologies are still unable to measure ICP value in pressure units without the calibration of a system – something that is needed to eliminate systematic errors of proposed non-invasive methods. There is a growing demand for non-invasive ICP measurement and monitoring technologies in wider fields of medicine outside of neurosurgical intensive care units.
The only technologies that are clinically available for intracranial pressure (ICP) monitoring are invasive. How did the development of the two depth transcranial Doppler come about? In this follow-up article, we speak to Arminas Ragauskas – the developer of the two depth Transcranial Doppler technology that enabled researchers to non-invasively measure the intracranial pressures of patients. In a recent article, we covered new research from the Kaunas University of Technology that has identified translaminar pressure difference and lowered intracranial pressure as possible risk factors for normal tension glaucoma. Two depth TCD technology at the DLR center, Cologne
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