R . G . A . Ackerstaff

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Barbiturate therapy or hypothermia precludes proper diagnosis of brain death either clinically or by EEG. Specific intracranial flow patterns indicating cerebral circulatory arrest (CCA) can be visualized by transcranial Doppler ultrasonography (TCD). The aim of this study was to assess the validity of TCD in confirming brain death. Meta-analysis of studies(More)
BACKGROUND The strategy for treating patients with severe asymptomatic carotid artery stenosis and cardiac disease remains unresolved. Staged or combined carotid endarterectomy in these patients offers the potential benefit of decreased neurological morbidity during and after cardiac surgery; however, in high-risk patients with severe coronary artery(More)
Background and Purpose—The outcomes of carotid endarterectomy (CEA) are, in addition to patient baseline characteristics, highly dependent on the safety of the surgical procedure. During the successive stages of the operation, transcranial Doppler (TCD) monitoring of the middle cerebral artery (MCA) was used to assess the association of cerebral(More)
Intracerebral haemorrhage is a serious complication after carotid endarterectomy. We tried to identify predictors of this event. Two-hundred-and-thirty-three operations were selected from a total of 280 because of reliable intraoperative transcranial Doppler data with regards to the increase of peak blood flow velocities and pulsatility indices in the(More)
OBJECTIVES to investigate whether transcranial Doppler (TCD) monitoring can identify patients at risk of hyperperfusion, and whether active postoperative treatment of selected patients decreases the risk of intracerebral haemorrhage (ICH). DESIGN a case cohort study of 688 patients undergoing carotid endarterectomy (CEA) with intraoperative TCD(More)
OBJECTIVES To prospectively document the incidence, location, risk factors for and clinical consequences of restenosis after carotid artery angioplasty and stenting (CAS). METHODS Serial duplex and neurological examinations were performed in 217 patients one day (n = 216), 3 (n = 189), 12 (n = 129) and 24 (n = 48) months, after CAS. The relationship(More)
OBJECTIVE The outcomes of carotid angioplasty and stenting (CAS) are, in addition to patient baseline characteristics, highly dependent on the safety of the endovascular procedure. During the successive stages of CAS, transcranial Doppler (TCD) monitoring of the middle cerebral artery was used to assess the association of cerebral embolism and hemodynamic(More)
OBJECTIVE Identification of predictors of intracerebral haemorrhage after carotid endarterectomy. DESIGN Retrospective comparison of patients who developed intracerebral haemorrhage and patients who did not, with special attention to intraoperative transcranial Doppler monitoring of the ipsilateral middle cerebral artery and postoperative signs and(More)
OBJECTIVES To determine the diagnostic value for predicting cerebral hyperperfusion syndrome (CHS) by adding a transcranial Doppler (TCD) measurement in the early postoperative phase after carotid endarterectomy (CEA). DESIGN Patients who underwent carotid endarterectomy between January 2004 and August 2010 and in whom both intra- and postoperative TCD(More)
BACKGROUND AND PURPOSE The main purpose of carotid endarterectomy (CEA) for neurologically symptomatic high-grade extracranial carotid artery stenosis is to remove the suspected source of cerebral microemboli. Transcranial Doppler (TCD) ultrasonography has the potential for detecting solid microemboli in the basal cerebral arteries. Therefore, TCD(More)