Transcranial Doppler equipment grants

[Sarah Tee]

The University of Utah has its TCD up and running:

https://healthcare.utah.edu/neurosciences/neuroradiology/transcranial-doppler

The autonomic specialist who received the grant is Dr Melissa Cortez, director and founder of the autonomic physiology laboratory at the university

https://healthcare.utah.edu/find-a-doctor/melissa-cortez

 

And Johns Hopkins autonomic specialists can presumably order testing for you too:

https://www.hopkinsmedicine.org/neurology-neurosurgery/specialty-areas/neurovascular-laboratory/transcranial-doppler

[Sarah Tee]

Just adding an article on the history of TCD. It was invented way back in the 70s and 80s, when various doctors started experimenting with trying to measure the arteries to and in the brain.

https://journals.sagepub.com/doi/full/10.1177/1544316720976210

Note that this article doesn’t mention its use in dysautonomia. But it may be of interest anyway. Lots of graphics showing how they aim at the arteries through the skull. Not easy.

I did find an article from Japanese researchers using it to investigate postural dizziness in 1979. Wow! (Article title was the only bit that got translated.)

https://pubmed.ncbi.nlm.nih.gov/508434/

I have noticed a fair bit of research on autonomic and specifically orthostatic intolerance problems comes from Japan, Korea and China. I wonder if they are ahead in everyday diagnosis and treatment as well.

[Sarah Tee]

I also found a bunch of articles from the 90s with Dr Novak, Dr Low (presumably the Low who cowrote the paper with Schondorf naming POTS?) and Dr Judith Spies, an Aussie who was interning in the US and who now runs an autonomic lab in Sydney.

This makes me even more angry that my autonomic specialist, who was not even born when all this was going on, but still knows next to nothing about TCD, did not know there was one in a hospital in the city he lives and works in, and has shown no interest in ordering it for his patients.

https://pubmed.ncbi.nlm.nih.gov/?term=novak low doppler&sort=pubdate&sort_order=asc

[MikeO]

@Sarah TeeGood job on the detective work. Do you think that you could get a Consultation visit with Dr Judith Spies?

[Sarah Tee]

@MikeO, haha, you read my mind! I did investigate but it didn’t look promising for various reasons.

We are taking one more shot at my specialist next appt to get him to pull himself together and order the test.

If he doesn’t come through, I will try a neurologist locally and Dr Spies. Maybe I can make my specialist write to her!

[Sarah Tee]

Quote from Dr Peter Rowe in Stat Health press release:

Quote

Cerebral blood flow (CBF) is the critical missing vital sign – poor CBF is the cause of common orthostatic symptoms such as dizziness and brain fog. My Dutch colleagues have measured this with ultrasound on over a thousand patients. However, it’s not easy to measure CBF, so most clinics approximate using secondary metrics of heart rate and blood pressure, which often mislead. Unfortunately, this frequently leads to the wrong conclusion that the symptoms are just psychological, when in fact, there are physiological abnormalities.

That’s just what I was saying the other week 🙂

[Sarah Tee]

Just another note: I have read that TCD ultrasound is being used in intensive care, mostly for neurological problems such as subarachnoid haemorrhage. But still, the more doctors that know of it in any context the better.