DETECTION OF MCA EMBOLIZATION DURING TRANSCRANIAL DOPPLER MONITORING

Continuous transcranial Doppler ultrasound (TCD) monitoring of the mid dle cerebral artery (ACM) is a potent new technique in detecting throm boembolic and haemodynamic complications in interventional neuroradiol ogy. An illustrative case is reported of a 6-year-old boy suffering fr om right-sided rhabdomyosarcoma of the neck in which permanent balloon occlusion of the right ACI was attempted. During the procedure, repea ted severe thromboembolic events with temporary occlusion of the M1 se gment of the ACM could be detected by TCD monitoring. Complications co uld then be avoided by cessation of the undertaking and lysis therapy with urokinase. The report concludes that TCD monitoring during endova scular treatment provides important insight into the thromboembolic pa thophysiology, guides management strategies, helps in the avoidance of devastating events and should be performed during all interventional procedures, as well as during balloon occlusion of the ACI.