1. Transcranial Doppler screenshots of Spencer shunt grades are shown for examples of cases missed by transoesophageal echocardiography with sedation.
Transcranial Doppler screenshots of Spencer shunt grades are shown for examples of cases missed by transoesophageal echocardiography with sedation. It can be seen that the presence of bubbles in the cerebral arteries is obvious; besides the visual output on the screen, a loud signal is heard from the audio output with each bubble crossing the patent foramen ovale. Grade 0, no microemboli detected; grade 1, 1–10 microemboli; grade 2, 11–30 microemboli; grade 3, 31–100 microemboli; grade 4, 101–300 microemboli; grade 5, >300 microemboli. (Reproduced with permission of Elsevier from Tobe et al 7)‏
J David Spence Stroke Vasc Neurol 2018;3:76-83
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