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List J, Röhl JE, Doepp F, et al. Transcranial ultrasound analysis of cerebral blood flow during induced hypertension in acute ischemic stroke - a case series. Crit Ultrasound J. 2013;5(1):4doi: 10.1186/2036-7902-5-4.
List, J., Röhl, J. E., Doepp, F., Valdueza, J. M., & Schreiber, S. J. (2013). Transcranial ultrasound analysis of cerebral blood flow during induced hypertension in acute ischemic stroke - a case series. Critical ultrasound journal, 5(1), 4. https://doi.org/10.1186/2036-7902-5-4
List, Jonathan, et al. "Transcranial ultrasound analysis of cerebral blood flow during induced hypertension in acute ischemic stroke - a case series." Critical ultrasound journal vol. 5,1 (2013): 4. doi: https://doi.org/10.1186/2036-7902-5-4
List J, Röhl JE, Doepp F, Valdueza JM, Schreiber SJ. Transcranial ultrasound analysis of cerebral blood flow during induced hypertension in acute ischemic stroke - a case series. Crit Ultrasound J. 2013 Apr 08;5(1):4. doi: 10.1186/2036-7902-5-4. PMID: 23566412; PMCID: PMC3636078.
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Crit Ultrasound J. 2013 Apr 08;5(1):4. doi: 10.1186/2036-7902-5-4.

Transcranial ultrasound analysis of cerebral blood flow during induced hypertension in acute ischemic stroke - a case series.

Critical ultrasound journal

Jonathan List, Jens E Röhl, Florian Doepp, José M Valdueza, Stephan J Schreiber

Affiliations

  1. Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany. [email protected].

PMID: 23566412 PMCID: PMC3636078 DOI: 10.1186/2036-7902-5-4

Abstract

BACKGROUND: Current recommendations of stroke treatment favour a moderately elevated blood pressure in the acute phase, based on the concept of an improved cerebral perfusion. Here, cerebral blood flow was assessed in a case series of patients with acute hemodynamic stroke by means of transcranial colour-coded sonography (TCCS) to study the effects of pharmacologically induced hypertension.

FINDINGS: We investigated six patients with acute hemodynamic stroke and blood pressure-dependent clinical fluctuation of neurological symptoms. TCCS was performed during the initiation phase of catecholamine-induced controlled hypertension. A blood pressure-dependent increase of flow velocity in the ipsilesional middle and the posterior cerebral artery was found in all patients (mean increase 0.80% and 0.65% per mmHg, respectively).

CONCLUSIONS: Catecholamine-induced hypertension in severe hemodynamic stroke leads to an ultrasound-detectable rise of cerebral blood flow. This finding gives 'proof-of-principle' evidence, supporting active blood pressure management in this selected group of stroke patients. Outcome-related questions of target blood pressure, treatment duration or applicability to other forms of stroke, however, remain to be studied. In this, transcranial ultrasound may be a valuable tool for patient selection and subsequent bedside monitoring.

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