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Updated: May 12, 2025
Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Cerebral Hemodynamic Alterations in Dialysis COVID-19 Survivors: A Transcranial Doppler Ultrasound Study on
José Lapeña-Motilva1, Daniel Fouz-Ruiz2, Mariano Ruiz-Ortiz1
1Department of Neurology, 12 de Octubre University Hospital, Av. de Córdoba, s/n, 28041 Madrid, Spain.
Background:
We observed a COVID-19 survivor with a ventriculoperitoneal shunt who developed increased intracranial pressure during hemodialysis. We hypothesized that post-SARS-CoV-2 infection, patients may have altered cerebral perfusion pressure regulation in response to intracranial pressure changes.
Methods:
From April to July 2021, we recruited dialysis patients with prior COVID-19 from two Madrid nephrology departments. We also recruited age- and sex-matched dialysis patients without prior SARS-CoV-2 infection. Transcranial Doppler ultrasound was used to measure the middle cerebral artery velocity before dialysis and 30, 60, and 90 min after the initiation of dialysis.
Results:
The final sample included 37 patients (16 post-COVID-19 and 21 without). The COVID-19 survivors showed a significant pulsatility index increase between 30 and 60 min compared to those without COVID-19. They also had lower heart rates.
Conclusions:
We propose two mechanisms: an increase in intracranial pressure or a decreased arterial elasticity. A lower heart rate was also observed in the COVID-19 survivors. This study highlights SARS-CoV-2's multifaceted effects, including potential long-term vascular and cerebral repercussions.
