Objective: We sought to determine the utility of constrat-enhanced transcranial color sonography (TCCS) in the diagnosis of cerebral circulatory arrest in cases of difficult acoustic window.
Materials and methods: From January 2007 to July 2008, we prospectively studied 50 patients who fulfilled clinical criteria of brain death. In all cases, we performed TCCS aiming to insonate both middle cerebral arteries (MCA) and the basilar artery (BA). In those case in which insonation of any vessel was not possible, we repeated the exploration after injecting a 2.5-mL bolus of sulphurhexafluoridedispersion. Afterward, we compared the rate of insonation of the vessels and the number of conclusive studies.
Results: The mean patient age was 53.2 +/- 15.9 years. Thirty-two were men (64%). The most frequent neurologic injury was hemorrhagic stroke and traumatic brain injury. Contrast-enhanced TCCS resulted in an increased rate of insonation in both MCA and in BA, and in the number of conclusive studies.
Conclusions: Contrast-enhanced TCCS increased the number of conclusive studies with cerebral circulatory arrest, which minimized the importance of a previous study in cases with a poor acoustic window.