Transcranial Doppler combined with quantitative electroencephalography brain function monitoring for estimating the prognosis of patients with posterior circulation cerebral infarction

Abstract

Background: Posterior circulation cerebral infarction (PCCI) leads to decreased cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional CBF both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) can evaluate neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate its efficacy in predicting the prognosis of patients with PCCI.Methods: We used TCD-QEEG to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta+theta)/(alpha+beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Results: Forty patients (aged 63.7±9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD (hazards ratio [HR] 0.168, confidence interval [CI] 0.047–0.597, p=0.006), and QEEG indicators of DTABR (HR 12.527, CI 1.637–95.846, p=0.015) were the independent predictors of the clinical outcomes. The AUROC after the combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p<0.05).Conclusion: TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.

Laser speckle contrast imaging for blood flow monitoring in predicting outcomes after cerebral ischemia-reperfusion injury in mice

“…Cerebral blood flow plays a very important role in maintaining normal physiological function in human beings. The monitoring of cerebral blood flow is conducive not only to exploring the pathophysiological changes in blood flow in local lesions in ICS and other brain diseases [14,15] but also to improving the efficiency of 3 Relationships between cerebral cortical blood flow monitored by LSCI and the degree of brain tissue injury. The lower the cerebral blood flow value was, the more severe the degree of brain tissue injury was.…”

Diffusion‐Weighted Imaging Image Combined with Transcranial Doppler Ultrasound in the Diagnosis of Patients with Cerebral Infarction and Vertigo

“…e general clinical diagnosis is based on brain structure imaging and cerebrovascular imaging. Among them, TCD is a noninvasive examination method used to evaluate the hemodynamics of the skull base arteries, which can more sensitively reflect the functional status of the cerebrovascular [14,15], but it has some shortcomings, which is embodied that it fails to guarantee the incident angle of ultrasound, reducing the accuracy of repeated measurement of blood flow velocity. DWI can detect the size and location of the lesion in the ultra-early stage of onset, and it can also detect some small infarcts in the brainstem and cerebellum [16][17][18].…”