Reevaluating the transcranial Doppler criteria for estimation of anterior circulation artery stenosis: transcranial Doppler sonography versus digital subtraction angiography

Detection of Cerebral Vasculopathy by Transcranial Doppler in Children With Neurofibromatosis Type 1

Neurofibromatosis type 1 is characterized by nerve sheath neurofibromas associated with a number of additional clinical features, including cerebrovascular disease. The aim of this study was to use transcranial Doppler as a screening method for identifying cerebral vasculopathy in children with neurofibromatosis type 1. Forty children with neurofibromatosis type 1, aged 5 to 18 years old, were examined by transcranial Doppler. Patients presenting with hemodynamic features of arterial stenosis/occlusion on transcranial Doppler underwent magnetic resonance angiography to confirm the findings. Magnetic resonance angiography was performed on 4 children who exhibited a transcranial Doppler hemodynamic pattern indicative of cerebral vasculopathy. Among these cases, 2 presented internal carotid artery stenosis/occlusion, 1 had bilateral middle cerebral artery stenosis, and 1 presented a normal magnetic resonance angiography result. Transcranial Doppler can be used routinely in the investigation of cerebrovascular disease in neurofibromatosis type 1 patients, where magnetic resonance angiography can be subsequently applied to confirm the diagnosis, further contributing to the prevention of cerebrovascular events.

Middle cerebral artery dissection: diagnostic and prognostic value of transcranial color-coded sonography

We report 2 patients with ischemic stroke related to an initial severe focal narrowed middle cerebral artery caused by a dissection mechanism, a presentation that has received little attention to date. Diagnostic modalities and follow-up using transcranial color-coded sonography are reported and discussed. Results with transcranial color-coded sonography were correlated with computed tomographic angiography, showing the great value of this radiation-free arterial monitoring process in this setting, especially in young adults.