Assessing dynamic cerebral autoregulation after stroke using a novel technique of combining transcranial Doppler ultrasonography and rhythmic handgrip

Dynamic cerebral autoregulation (CA) is impaired after stroke. Methods employed to assess this phenomenon usually involve deliberate alterations in blood pressure (BP) by physical means. We performed a pilot study to assess dynamic CA in acute stroke patients using a novel technique of combining transcranial Doppler (TCD) ultrasonography with rhythmic handgrip. Ten patients with ischaemic stroke in the middle cerebral artery (MCA) territory were studied. We performed continuous recordings of bilateral MCA velocities and used rhythmic handgrip to induce BP oscillations. Changes in autoregulation were indicated by changes in phase shift and gain of MCA velocity in relation to BP. Patients were examined at