Transcranial Doppler Clinical Applications
The NeuraSignal Platform It is used to diagnose a wide range of conditions affecting blood flow to, and within, the brain.
Cerebral hemodynamics are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke.
A cerebral embolism occurs when a blood clot forms in another part of the body, often the heart or arteries in the upper chest and neck, and moves through the bloodstream until it hits an artery too narrow to let it pass.
Morphology provides physicians with advanced analysis of TCD waveforms to enable faster and easier assessment of patients with suspected neurological conditions, including stroke.
Explore the role of Transcranial Doppler (TCD) in managing post-cardiac arrest syndrome. Learn how real-time cerebral blood flow monitoring with NeuraSignal’s NG2 aids in neuro-prognostication and preventing secondary brain injury.
Intracranial atherosclerotic disease (ICAD) is characterized by the narrowing or blockage of arteries within the brain due to the accumulation of atheromatous plaques in the arterial walls.
Cerebrovascular reactivity (CVR) — also called vasomotor reactivity (VMR) — is the ability of cerebral blood vessels to dilate or constrict in response to metabolic stimuli such as changes in arterial carbon dioxide (CO₂) levels.
Transcranial Doppler (TCD) ultrasonography confirms brain death by detecting cerebral circulatory arrest (CCA) — the cessation of blood flow to the brain caused by rising intracranial pressure exceeding arterial perfusion pressure.
Cerebrovascular reserve (also called cerebral vasomotor reactivity) refers to the brain’s ability to increase cerebral blood flow (CBF) in response to a vasodilatory stimulus.
BUBL Trial Clinical Trial Results1
NG2 Intelligent Ultrasound compared to standard of care TTE for RLS detection
>3X
shunt detection rate
63.6% with NG2, 20.9% with TTE
2.7X
detection of intervenable shunts
27% with NG2, 10% with TTE
Read the full results from this groundbreaking study
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TCD Applications
The NeuraSignal Platform provides rapid, noninvasive, real-time measures of cerebrovascular function. Physicians and accreditation commissions recommend TCD as a highly accurate and sensitive test for patients with stroke or stroke-like symptoms. It is used to diagnose a wide range of conditions affecting blood flow to, and within, the brain.
In a recent study with non-expert TCD operators, the NeuraSignal Platform exhibited a >3X detection rate for a right-to-left shunt (RLS) and a 2.7X detection rate for patients with large, intervenable shunts as compared to standard of care transthoracic echocardiography (TTE).3 Without appropriate diagnosis and intervention, many of these patients are at a high risk of stroke recurrence. Furthermore, the autonomous, robotic headset makes it easy for a bubble study to be completed by one person, helping to alleviate personnel shortages.
After a subarachnoid hemorrhage (SAH), guidelines state that patients should receive daily TCD monitoring. Thanks to its ease of use, NG 2 enables TCD exams to be performed any time of the day or night, giving clinicians the ability to immediately monitor a patient if their condition is deteriorating. The exam does not subject patients to harmful radiation and can reduce the number of CT-As performed. A prospective study demonstrated that the use of TCD combined with clinical management of post-SAH patients could reduce ICU stays by an average of 8 days, or $24,000 per patient.4
TCD is the only diagnostic modality able to assess blood flow in the brain in real time.5 By using the NeuraSignal Platform to monitor changes in cerebral hemodynamics during a procedure, clinicians can identify potential complications and take appropriate action to prevent ischemia or other adverse outcomes while the patient is still in the OR. TCD is currently the gold-standard test to detect, localize, and quantify cerebral embolism. It has been used in aortic surgery to confirm cerebral perfusion and during cardiopulmonary bypass surgery to monitor microemboli.
After mechanical thrombectomy, it is crucial to monitor blood flow in the brain to quickly detect any complications that may arise. The NeuraSignal Platform provides continuous monitoring of cerebral hemodynamics, helping clinicians to quickly and easily identify changes indicative of complications like reocclusion or hemorrhage. TCD has been successfully used to guide post-thrombectomy blood pressure management for the prevention of complication and injury.6
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By providing noninvasive monitoring of cerebral hemodynamics, the NeuraSignal Platform can reduce the need for more invasive and costly procedures, delivering cost savings and increasing efficiency.
With real-time information, clinical teams can make more informed decisions about patient management, leading to reduced length of stay and improving patient outcomes.
With the NeuraSignal Platform, healthcare professionals can detect and manage complications more quickly, helping to prevent adverse outcomes, reduce hospital readmissions, and ultimately leading to better patient satisfaction.
References
- Rubin, M., Shah, R., et al. Novel Robotic-Assisted Transcranial Doppler versus Transthoracic Echocardiography to Detect Right-to-Left Shunts. New Orleans, LA USA: International Stroke Conference – Late Breaking Abstract.