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Related Experiment Videos

Transcranial Doppler sonography in experimental Cushing response

G Stepińska1, Z Czernicki, J Berdyga

  • 1Department of Neurosurgery, Polish Academy of Sciences, Medical Research Center, Warsaw, Poland.

Acta Neurochirurgica
|January 1, 1995
PubMed
Summary

Early warning signs of brain ischaemia were investigated using transcranial Doppler sonography (TCD) in cats. Basilar artery (BA) flow changes detected by TCD indicate brain stem ischaemia, while middle cerebral artery (MCA) monitoring may be misleading.

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Area of Science:

  • Neuroscience
  • Veterinary Medicine
  • Medical Imaging

Background:

  • Brain ischaemia poses a significant risk, and early detection of symptoms is crucial for timely intervention.
  • The Cushing response, characterized by increased intracranial pressure and hypertension, is a critical indicator of potential brain stem compromise.
  • Transcranial Doppler sonography (TCD) is a non-invasive technique used to assess cerebral blood flow, but its application in detecting early ischaemic changes requires further investigation.

Purpose of the Study:

  • To identify early warning symptoms of brain ischaemia using TCD in a feline model.
  • To evaluate the utility of monitoring middle cerebral artery (MCA) and basilar artery (BA) blood flow during the Cushing response.
  • To determine if TCD can reliably detect changes indicative of brain stem ischaemia.

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Main Methods:

  • Seven cats were studied, with intracranial pressure increased via lumbar infusions to induce the Cushing response.
  • Transcranial Doppler sonography (TCD) was employed to analyze blood flow patterns in the MCA and BA.
  • Flow changes were assessed during the initial stages of significant systemic blood pressure increase associated with the Cushing phenomenon.

Main Results:

  • The onset of the Cushing phenomenon was associated with alterations in the basilar artery (BA) flow pattern.
  • The middle cerebral artery (MCA) flow remained unchanged during the initial stages of the Cushing response.
  • These findings suggest that BA monitoring is a more sensitive indicator of early brain stem ischaemia than MCA monitoring.

Conclusions:

  • Monitoring basilar artery (BA) blood flow using TCD is essential for detecting early signs of brain stem ischaemia.
  • Relying solely on middle cerebral artery (MCA) TCD monitoring during the Cushing response may be misleading and could delay critical interventions.
  • TCD of the BA offers a more reliable approach for identifying cats at risk of brain stem ischaemia.