Investigations on oscillating flow spectra as a Doppler ultrasonographic sign of intracranial circulatory arrest.

Abstract

In a total of 90 patients with intracranial hypertension and subsequent intracranial circulatory arrest, the cerebral basal arteries were examined with transcranial Doppler ultrasonography. In order to explain the development of the various forms of oscillating flow, a blood-pressure cuff was placed on the distal forearm of 25 healthy subjects to investigate the flow spectra in the proximal arteries in the presence of increasing stream resistance. With raising the pressure of the cuff, the changes in the Doppler sonographic flow spectra were simulated as in case of increasing intracranial pressure. As intracranial pressure increases at constant systemic blood pressure values, the flow velocity spectrum changes in a typical manner. At the stage of oscillating flow, characteristic changes in the flow spectra can be observed. Investigations showed that compliance is reduced in a distal to proximal direction. This means that a different frequency spectrum can be recorded in distal branches of the middle cerebral artery than in the proximal carotid artery at the same point in time. By examining the flow velocity spectra from the brachial artery, it was possible to understand better the typical course of an intracranial circulatory arrest resulting from increased stream resistance.