Background and Purpose-Vertebrobasilar ischemia has been attributed to a reduction of net vertebral artery flow volume, the product of mean flow velocity and the cross-sectional area of the vessel. It can be determined by duplex sonography. There are no reference values for vertebral artery flow volume in an age group representative of patients with cerebrovascular disease. Methods-We examined 50 nonvascular neurological patients (age 55.8Ϯ14.0 years). Flow velocities and vessel diameters were recorded in the intertransverse (V2) segments bilaterally, and the flow volume was calculated according to the following equations: (1) Q1ϭtime-averaged mean velocityϫarea and (2) Q2ϭ(time-averaged maximum velocity/2)ϫarea. Results-Flow velocities and vessel diameters tended to be lower on the right side, resulting in a lower flow volume. Flow volumes (according to Equation 1) were 77.2Ϯ29.8 mL/min on the right side, 105.3Ϯ46.4 mL/min on the left side, and 182.0Ϯ56.0 mL/min net. Side-to-side differences were not significant. Flow volumes calculated with the 2 equations did not differ significantly. An age dependence could not be shown, but vessel diameters and net vertebral artery flow volumes were significantly lower in women than in men. The normal range for net vertebral artery flow volume defined by the 5th to 95th percentiles is between 102.4 and 301.0 mL/min. This wide range is due to the high interindividual variability of the parameters. Conclusions-On

No abstract

Ultrasound is a viable and non-invasive method in the investigation of laryngeal elevation during swallowing. It allows direct visualization of impaired laryngeal motion in patients with neurogenic dysphagia.

The duration of retrograde flow clearly discriminates competent and incompetent valves. On the basis of our results, we provide cut off values that help differentiate between physiological and insufficiency reflux. The differences in peak velocity and morphology criteria are helpful but not reliable to predict insufficiency of the valve.

TGA is associated with an increase in the prevalence of jugular insufficiency. Valvular insufficiency may lead to increased venous pressure transmission during a Valsalva maneuver and thus contribute to venous ischemia in TGA. The association of valvular insufficiency and longer reflux times with the occurrence of a trigger event further suggests that cerebral venous congestion is an important etiological factor in transient global amnesia.