Related Experiment Video
Updated: Jun 23, 2026
04:01
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
TCD systolic spikes in a malignant MCA infarct
Jesus Perez-Nellar1, Claudio Scherle, Calixto Machado
1Hermanos Ameijeiras Hospital, Service of Neurology, Havana, Cuba. jesus.perez@infomed.sld.cu
Neurocritical Care
|April 22, 2009
Summary
Malignant middle cerebral artery (MCA) infarction causes brain swelling and increased intracranial pressure (ICP). This case study reveals asymmetric Doppler findings in the affected hemisphere, suggesting localized pathophysiologic mechanisms.
Area of Science:
- Neurology
- Neuroimaging
- Cerebrovascular Diseases
Background:
- Malignant middle cerebral artery (MCA) infarction presents with significant space-occupying effects and increased intracranial pressure (ICP).
- High mortality rates associated with malignant MCA infarction necessitate further understanding of its pathophysiology.
Observation:
- A patient presented with acute neurological deficits including slurred speech, right hemiplegia, and reduced consciousness.
- Computed tomography (CT) confirmed a large cerebral infarct within the left MCA territory.
- Transcranial Doppler (TCD) revealed normal flow in the right hemisphere but abnormal systolic spikes without diastolic flow in the left internal carotid artery, anterior cerebral artery, and MCA.
Findings:
- The observed TCD findings indicate a critical flow disturbance within the left cerebral vasculature.
- Asymmetric Doppler patterns suggest localized pathophysiologic processes within the affected hemisphere.
Implications:
- These findings suggest that the pathophysiologic mechanisms initiating brain damage (BD) in malignant MCA infarction may begin asymmetrically within cerebral hemispheres.
- Understanding these asymmetric mechanisms could inform targeted therapeutic strategies for malignant MCA infarction.
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