Has anybody had any experience with a Transcranial Doppler Ultrasound?  From what I researched on the internet, it is basically an ultrasound that can detect and measure blood flow.  I'm interested to find out about other's experiences...did it help with providing vital information?  did it prove accurate?  how often does one have this done? etc...

If you don't mind sharing, I'd like to hear from you.  I'm getting ready to have this procedure done.

Thank you!

Take care,
Shan

Shan,

Using the TDU is a standard of practice at Stanford.  I think I can safely say that all MM surgery patients there (at least the adult ones) have it done both before and after surgery, sometimes multiple times after surgery.  

I'm not sure if or how often it is used at other institutions, but will be interested to hear the feedback.

Jill

I'll just echo what Jill said as I had surgery at Stanford.  I had a TDU done the day before surgery, the day after surgery, and I think twice in the days before I was discharged.  I believe I had a total of 4.  I know they got great information from it.  The technician was amazed at the difference just one day after my surgery.  It was completely painless...just cold gel!!  Obviously it was a tad more sensitive after the surgery but not bad at all.  If they will let you watch the screen, do it.  It was pretty neat!  Good luck!!  After all you've gone through, this will be one of the easiest things!!
Chelsie

Hi Shan.

I had several TDU at Stanford.
Who can forget Joanne The Doppler Lady!
She was sooo much fun.

MM Friend
Kevin

8)
Ji Shan,  I've jad 3 or 4 of them.  They're called a TCD I guess because the ulyrasound part is a given.  
    It's a non invasive piece of cake.
    You breathe in a Co2 mixture during part of the test and this causes the bloodvessels in your brain to dialate from a lack of oxygen thus giving a better picture of how flexable the vessels are under stress.
    The TCD is also an accurate indicator of your corotid blood flow.
    The other axurate blood flow test is a Perfusion MRI.
Hope I was some help [smiley=huh.gif]
    Stay healthy,   Yom G

Thank you very much for all your responses!  ;;D  From the sound of things there's really nothing I should be too worried about.  ;)  My first thought was "why do I have to have this done?"...and now, it's "how come I didn't have this done earlier?"   [smiley=huh.gif]

Although I won't be having "Joanne The Doppler Lady," ;) I'm actually now looking forward to having this procedure!  Thanks a million for sharing your TDU experiences with me!  It has truly brought me a sense of comfort to know that 1) it doesn't hurt and 2) many of you have had this done on numerous occasions!  ;;D  I'll let y'all know how it goes...

Muchos Mahalos!  [smiley=hug.gif]

Take care,
Shan

Hey all:

I just want to clarify something that Tom mentioned.  I have had TCDs done at Columbia (where Tom had his done) and at Stanford.  If my understanding is correct, not all TCDs have the CO2 portion done.  That is a test that Columbia does, where they do the regular TCD, and then do what is called a CO2 reactivity test, where they do what Tom mentioned as a comparison.  Shan, you will not necessarily have to do the CO2 portion.  

Shan, just curious--did you not have TCDs done during surgery?  I had my surgeries done at Stanford, and they do them almost everyday (prior, & after) -- I too was lucky to have Joann, she's the greatest!  I'm curious b/c I thought all docs requested them, esp. during the surgery.  Though I did ask Teresa (Steinberg's right hand) about the meaning of the numbers and she did say it's just a point of reference that it doesn't determine improvement necessarily (that the MRIs/angiogram really determine that).  She also pointed out that the point of reference is different for different people, which is why they do the before and after.

Trina

Hi Trina,

No, I've never had this procedure done before.  I know pre-surgery, like hours before my surgery, I first had a cardio stress test to see if my  [smiley=heart.gif] could withstand the surgery due to other medical concerns, and then I had a cerebral angiogram.  Then, about an hour or two later, I was taken in for surgery.  

I was actually diagnosed (by my THIRD opinion) with MM on a Wednesday evening at about 4 pm and told that I had to get to NC to have my surgery by that weekend, so luckily we were able to catch a flight out that night to Pheonix at 10 pm, and then arrive in NC on Thursday am where I immediately checked in to the NICU straight from the Raleigh-Durham airport.  Friday morning is when all the tests began...and then my surgery Friday afternoon.  It was quite a whirlwind of an experience.  I remember having CT scans the first couple of days after my surgery, as well as another cardio (adenosine) test about 10 days post-op.  And since then, I've had a CTA, MRI/MRA, EEG and now getting ready for a TDU..and a sleep study.  I agree that from the looks of it, a TDU sounds like a breeze at this point.... ;;D

Take care,
Shan

Hi all!

Just my experience...but not all docs necessisarily do these tests.  Way back when, Dr. Scott, didn't order these, since I've never had one.  He may use them now, but I know that I've never had one.

Renee

FYI...I never had one with all my visits to Dr. Scott.

-Shari

Shan,

This is from the post at the top of this board "Diagnostic process and questions for surgeons"


DJ wrote on Jun 10^th, 2004 at 1:46pm:

Initial tests (in order): transcranial doppler (ultrasound of the carotid arteries), MRI (shows any stroke), MRA (shows any problems with the carotids), angiogram (shows the road map of the arteries in the brain and THE diagnostic test that shows the actual moyamoya vessels) [Nov 20, 2004 edit: I've edited the order of the "General Process" area above, moving the transcranial doppler from an additional test, to the first initial test. My logic is that the transcranial doppler shows good indication of blood flow through the carotid arteries. It is also a much more cost effective test to get the diagnostic process started, rather than jumping straight to the MRI/MRA. I hope this makes sense.]

Basically, the TCD puts the bloodflow into numbers in order to easily distinguish differences between the two sides.  Here is a basic example of what the numbers look like from my original study:

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or http://www.moyamoya.com/tcd.gif

It shows my right internal carotid averaged 29 and my left averaged 62.8.  BIG difference!

Does this make sense?

DJ,

Wow..thanks for the visual aid!  Yes, after reading everyone's posts and seeing your TDU results, it all makes sense now.  ;) From your TDU results, you can definitely compare both sides and see the difference.  Now, I can't wait to have mine done! (especially because I'm so worried about my "other" not yet operated on side!)

Thanks sooo much!!!!!

Take care,
Shan