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Stroke Prevention by TCD embolus detection


The EDS allows the neurologist to detect ongoing asymptomatic emboli floating to the brain. Emboli and especially solid emboli are under normal conditions never observed in the cerebral circulation. Emboli in the bloodstream means that there must be an unstable vascular lesion in the bloodstream that dislodge these herehito asymptomatic thrombi. But more important is that these asymptomatic emboli are strong predictors of bigger ones which may cause stroke. The current lecture addresses how neurologists can use TCD embolus detection in stroke prevention programs...

The Haga Braincare Strategy


The Haga Braincare Stragey has been developed to reduce the burden of focal and global ischemia related to cardiac surgery. It is a dual strategy in which patients with cerebral flow states are identified prior to surgery by TCD Ultrasound and in which patients are monitored per--operatively by non-invasive NIRS cerebral oximetry. In a retrospective follow-up study we noticed a the Haga Teaching Hospital an extinction of postoperative hemodynamic strokes and a > 50 % reduction of the post operative delirium...

Dutch version/English version in progress

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Prevention of Malignant Hyperfusion after Carotid Surgery or Angioplasthy


Cerebral hyperperfusion syndromes are reperfusion syndromes that may occur in the run off MCA territory after stenting or surgery of high grade ipsilateral carotid artery stenosis. Most of these hyperperfusion syndromes are transient phenomena with no residual brain lesions. However some of them result in a devastating hemorrhagic stroke. The main risk factors  of such a devastating stroke is when systemic hypertension and failed cerebral auto regulation interact with each other. Implementing intelligent TCD and RR management in these patients may prevent such devastating strokes...

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