DeWitt L D, Wechsler L R
Department of Neurology, Tufts University School of Medicine, Boston, Massachusetts.
Stroke. 1988 Jul;19(7):915-21. doi: 10.1161/01.str.19.7.915.
TCD recording of flow velocities in intracranial vessels was first described by Aaslid in 1982. The utility of this instrument becomes more apparent as it is used in different clinical settings and compared with angiographic findings (Figures 1 and 2). Its importance in early detection of vasospasm in subarachnoid hemorrhage is now clearly known; increased flow velocity can be documented prior to neurologic deterioration and thus allow early institution of therapy. In patients with stroke or transient ischemic attack of unclear etiology, especially in blacks, Orientals, or females, who have a higher incidence of intracranial arterial disease, TCD can be a very important noninvasive means for detecting stenosis of intracranial vessels. Its value for assessing collateral circulation, intraoperative monitoring, and measuring CBF is quite promising. Hopefully, through further work with TCD, we will be able to clarify the spectrum of its usages as well as its limitations, though the preliminary data indicate that it should be an important addition to present noninvasive evaluations.
1982年，阿斯利德首次描述了经颅多普勒（TCD）对颅内血管血流速度的记录。随着该仪器在不同临床环境中的应用，并与血管造影结果进行比较，其效用变得更加明显（图1和图2）。现在已经清楚地知道它在蛛网膜下腔出血早期检测血管痉挛中的重要性；在神经功能恶化之前就可以记录到血流速度增加，从而可以早期进行治疗。对于病因不明的中风或短暂性脑缺血发作患者，特别是颅内动脉疾病发病率较高的黑人、东方人或女性，TCD可以是检测颅内血管狭窄的非常重要的非侵入性手段。其在评估侧支循环、术中监测和测量脑血流量方面的价值很有前景。尽管初步数据表明它应该是目前非侵入性评估的重要补充，但希望通过对TCD的进一步研究，我们能够阐明其使用范围及其局限性。
