title: Transcranial Doppler ultrasonography in patients with moyamoya disease.
abstract: This study included 17 patients (five men and 12 women) with clinical diagnosis of Moyamoya disease from conventional angiograms. Bilateral basal arteries were measured by the transtemporal approach with a 2 MHz pulsed Doppler instrument (TC-2 64B EME). In 28 out of the 34 basal arteries (82.4%), reliable recordings were obtained. These transcranial Doppler ultrasonography (TCD) findings were classified into three patterns: (1) High-high pattern; the mean cerebral blood flow velocity (CBFV) was increased throughout the basal arteries by over 70 cm/s (seven arteries, 25.0%); (2) high-low pattern; the mean CBFV was fastest (over 70 cm/s) at the ICA or proximal MCA and the mean CBFV decreased remarkably distally (15 arteries, 53.6%); and (3) low-low pattern; the mean CBFV was less than 40 cm/s throughout the basal arteries (arteries, 15.4%). These CBFV patterns as assessed by TCD are compared with the patients age, clinical symptoms and angiographical stagings (Suzuki's criteria). The high-high pattern on TCD was predominantly seen in the younger patients and in the earlier stages of the disease. The high-low pattern was the most common pattern of CBFV as assessed by TCD in Moyamoya patients. The low-low pattern on TCD was more common in the later stages following angiographic evaluation by Suzuki's criteria. The above patterns based on TCD findings show a good correlation with the age of the patient and the clinical diagnosis at the onset. TCD appears to be very useful in the evaluation of patients with Moyamoya disease.
authors.affiliation: Department of Neurosurgery, Tokushima Prefectural Central Hospital, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takase
authors.forename: M
authors.initials: M
authors.lastname: Kashihara
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000000981:diagnostic imaging*; D017585:Ultrasonography, Doppler, Transcranial