This collaboration with Open University theoretical physicist, Dr Jim Hague, led to development of the first computational model of embolic stroke. The PhD student who performed this study, Dr Nikil Patel, was awarded a College PhD prize and the results of this study were published on the cover of Stroke. We compared the incidence, timing, and properties of bubbles released into the bloodstream during surgery with brain injury assessed using MRI and cognitive testing and found no links between the number or sizes of bubbles and brain injury. Dr Emma Chung) was the first to determine the size distribution of bubbles and volume of air entering the cerebral circulation during heart surgery. This British Heart Foundation (BHF) study (P.I. We are also investigating whether differing responses of solid and gas emboli to an acoustic radiation force could provide a reliable method for distinguishing between harmful solid emboli and benign gas bubbles. Dr Emma Chung) is investigating the feasibility of using an ultrasound acoustic radiation force to deflect emboli away from vital organs, such as the brain, during surgery. This Engineering and Physical Sciences Research Council (EPSRC) study (P.I. Detection and deflection of emboli in the bloodstream We are also investigating the potential for using an acoustic radiation force to deflect emboli away from the brain and to distinguish solid emboli from bubbles. Recent advances include the development of software to estimate the sizes of air bubbles entering the cerebral circulation during cardiac surgery, use of 'virtual patient' simulations to estimate the impact of bubbles on cerebral blood flow, and development of digital MR subtraction software to assist Radiologists in identifying new embolic lesions. Our research group has extensive expertise in the detection and characterisation of cerebral emboli using transcranial Doppler ultrasound. In a matter of fact, TCD is your stethoscope to the brain.A major cause of stroke comes from embolic debris (thrombus, bubbles and pieces of plaque) that travel through the cerebral circulation and become lodged in arteries supplying the brain. Also, the technique of color coated transcranial duplex made it possible to visualize the intracranial vessels and brain midline structures with a reliable index of accuracy and opened a wide door for new future research. It is widely used in assessing and following extra and intracranial vessels in a wide range of diseases, including stroke, subarachnoid hemorrhage, internal carotid artery stenosis, Moyamoya disease, sickle cell disease, mitochondrial cytopathies, arteriovenous malformations, patent foramen ovale and many others. TCD technology added a lot of information in understanding disease process affecting the intracranial vessels. Additional diagnostic criteria, such as flow direction, change or absence of signal, differences in velocity values on left and right sides, waveform shape, vasomotor reactivity, high intensity transient signal detection and others, are also used in interpretation. Blood flow velocity is calculated and used to make determinations about intracranial hemodynamics. TCD is used to assess blood flow velocity in the major basal intracranial arteries on a real time, beat-to-beat basis. The technique is very simple and has a high index of sensitivity and specifity. Simply, Transcranial Doppler (TCD) is a non invasive pulse wave ultrasonography of the intracranial blood circulation and it is one of the most rapidly growing sciences in neurosonology over the last decade. Transcranial Doppler, Your Stethoscope to the Brain. Part 2: TCD Clinical Applications by Dr.Waleed A Khoja Part 1: TCD Principles and Simulator by Dr.Waleed A Khoja This is a recording of the previously conducted live Course by Dr.Waleed A Khoja
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