TRANSCRANIAL COLOR-CODED DUPLEX SONOGRAPHY IN THE ADULT

Transcranial color-coded duplex sonography (TCCD) represents an improvement in ultrasound technology for study of the intracranial circulation. This new method was applied in 33 healthy volunteers and 63 neurological patients in order to study the following questions: (1.) how often can non-occluded intracranial arteries be delineated; (2.) reliability of pathological TCCD findings in comparison with cerebral angiography; (3.) reference blood flow velocity data. Results: 99% of vertebral (VA), 98% of basilar (BA), 96% of middle (MCA) and posterior cerebral (PCA), 95% of internal carotid (ICA; siphon and terminal segment), 93% of anterior cerebral (ACA), and 86% of posterior inferior cerebellar (PICA) arteries were delineated. In conjunction with the findings of extracranial color-coded duplex sonography (ECCD), 4 stenoses (2 MCA, 1 ICA and PCA each), 8 occlusions (4 ICA, 1 ACA, MCA, BA and VA each; differential diagnosis: subtotal stenosis), 9 collateral circulations (anterior and posterior communicating arteries in 4 cases each, occipital artery-intracranial VA in one), 4 cerebral arteriovenous malformations, and 2 giant aneurysms of the terminal ICA were suspected and confirmed by angiography. However, 2 hypoplastic VA's and ipsilateral PICA's were missed. (3.) Maximal +/- SD values were 83 +/- 27, 110 +/- 18, 67 +/- 12, 64 +/- 13, 53 +/- 13, and 51 +/- 12 cm/sec for systolic, and 36 +/- 9, 49 +/- 9, 30 +/- 7, 29 +/- 8, 24 +/- 7, and 25 +/- 7 cm/sec for end-diastolic velocity in the ACA, MCA, PCA, BA, VA, and PICA.