Wednesday, September 14, 2022


FOREWORD:  The Next Wellness Drivers of  Meditation (part 1)

Experience dictates that life will throw you an occasional brow-raising REPLAY of a prior landmark experience- what can only be called "no such thing as coincidences".   By this, a significant situation may re-occur when you least expect with one difference; you are older, more self aware and you look at experiences to be a profound source of wisdom.  This REPLAY may just be the universe trying to teach you an important lesson (and take it from Ferris Bueller), "if you pay attention, you might just learn something".

Such is the case about MEDITATION. 

I was introduced to the idea of meditation for restoring life balance, mental health and a wide range of personal benefits.  But sadly, the concept never took flight with me- as I could never get to that state of effect- turning my my failed attempts into a frustrating brick wall.  

Then one day, I met an unassuming Dave Dachinger during the launch of my online NYCRA group (NY Cancer Resource Alliance) around 2018- who successfully changed my entire perspective on what is apparently a centuries old medicine.   Mr. Dachinger is a retired firefighter and cancer survivor- with a body of knowledge that fit our cancer advocacy membership perfectly.  But what caught my attention about him was inventing an APP called LOVING MEDITATIONS for cancer patients undergoing the  physically taxing discomfort of infusion therapy (infusion therapy or chemo trickle).  

Dave receiving infusion
therapy (2014)
Dave himself had stage four cancer and found a calling for his creative brilliance during his "very stressful chemo "drip" sessions.  Implementing his talents as a professional musician, Dave built tracks for his IPod and incorporating meditational audio tapes to help him endure chemotherapy sessions.  The stress management effect of meditation is well supported in the scientific community and is further expanded by endocrinologists and mental health professionals.  "By lowering his cortisol and epinephrine levels, he is able to more safely endure the therapeutic experience.  But more importantly, those stress hormones that raise the sugars (glucose) in the bloodstream and elevates other physiological changes can actually alter the effects of any therapeutic intervention", says Dr. Howard Prince.

With a little kickstarter funding and a lot of entrepreneurial spirit, Loving Meditations was launched, earning significant international following in many circles including the functional health and wellness markets.  Meanwhile, Dave's digital harnessing of the fruits of meditation became a major reference of how brain health and stress reduction could both help the end road of any therapy.



About a year after my initial diagnosis of stage IV head and neck cancer, I had a follow-up visit with my oncologist "Dr. C." After my vitals were taken and blood drawn, we had a brief wait in the bleak exam room.

During this exam, Dr. C. announced that my scans were clear and I was now officially cancer-free. He commented, That was not an easy regimen (chemo, radiation and surgery) you just had, but you did phenomenally well!” He asked if there was actually something I did which helped me get through treatment in such good emotional and physical shape. I replied that Id used a mindful wellness practice, listening to programs at the infusion center. His eyes lit up as he suddenly proclaimed, Thats what I want for all of my patients!” He desired a way his patients could become calm before their exams or treatments.

As Dr. C. talked, Tamaras eyes and mine met and a light bulb lit up. Wed been creating the Miracle Mondays guided meditation series for seven years, and wed also recently lived through the cancer experience as patient and caregiver. Now my oncologist was pointing out a pain-point within his practice. As we exchanged huge smiles, we had our a-ha! moment: Loving Meditations was born.


Meditation has deep roots in research-based results., home of the journal Oncology, reported that mind-body practices like mindfulness meditation have been shown to positively affect quality of life and biological outcomes” when used by cancer patients and healthcare professionals. [1] Lets face it. Cancer and other major illnesses are scary, overwhelming, and stressful. How can we handle them with more ease?

[1], home of the journal Oncology Mindfulness Meditation” by Susan Bauer-Wu, PhD, RN Oct 19, 2010


HOW IT WORKS: The Loving Meditations App is available on two platforms, iOS (for iPad and iPhone) and Web App (for any device). For the free app download, go to The mindful wellness programs are delivered via the App to empower cancer patients, survivors and caregivers with self-love, self-care and self-discovery on their healing journey, from diagnosis to survivorship.

As you watch Loving Meditations, Tamaras calming voice, Davids expansive music and spectacular images shift you to a state of more calm. Our mindful techniques worked beautifully for us and also have helped thousands of people in over twenty countries.


REDUCING STRESS FOR PATIENTS: Imagine youre sitting in the infusion center hooked up to a cocktail of IV medications. You are expecting to be sitting there for a few hours, anticipating discomfort and with time on your hands. Then you remember you have the Loving Meditations app on your device. Finding the right meditation is as simple as opening the app and answering a few questions with the Adviser feature. For example, when the Adviser asks, Do you feel pain or discomfort?” you may choose to swipe right for yes, and the Adviser quickly guides you to helpful programs. Next, press play and enjoy the meditation. Whether you close your eyes and zone out or watch the beautiful images on the screen, youll be transported to a state of relaxation and tranquility.

By: Dr. Leslie Valle & the Prevention101 Editorial Team

During the Covid-19 surge, interviews with emergency medical professionals showed dramatic cases of ICU and ER responders exposed to major signs of advanced fatigue and risk of burnout.  This significantly raised major risks to their work performance where lives are to be affected, including theirs.  Over time, double and triple shifts resulted in "a different type of pandemic" on a national scale- where this level of exhaustion and overwhelm.  

Where a leave of absence, a vacation or regular rest is not an immediate option, we can start with addressing BRAIN HEALTH AND MENTAL HEALTH.  Modern meditation solutions (like BrainTap®, Loving Meditations® and other such technologies) are now available for exactly this emergent case as a portable personal "Rescue" dose. By tap ping the mind/body connection into a Vital Re-charge mode, we can induce a "Refresh- Revitalize-Renew" condition.  As with conventional meditation, bringing you into a regenerative meditative state offers that level of rest, clears the mind for renewed focus and new energy to continue with the 'battle' at hand. 

CALMING FOR SURVIVORS: Imagine youre scheduled for a follow-up scan and are beginning to feel anxious about the procedure and results. Looking at your device screen, you notice an inspiring quote there from Loving Meditations. Opening the app, you navigate to one of the Mindful Minute videos called Total Focus Breath, a super easy technique to use anytime, anywhere to quickly calm and quiet the mind. You follow the breathing technique for the next several minutes. Quickly, a sense of Ive got this” replaces panic.

WHAT, ME MEDITATE?  Weve heard folks say, Yeah, but I have no time to meditate!” Looking at it another way, we dont realize how many hours we actually spend watching the news, TV programs, or digital content on social media. Many of us devote significant time to this, sometimes to the point of addiction. Another common problem people mention about starting a mindful practice is that they cant stop thinking and their mind is too active” to meditate. They may have tried meditating in the past and found it difficult to sit and do nothing. Barraged by thoughts, they cant shut them out. What if it was as easy as putting in earbuds and pressing play on the Loving Meditations App?

HOW TO QUIET THE MIND:   Refrain from giving meaning or judgment to the thoughts, beliefs, fears, emotions, and feelings that will pop up during meditation. When they arise, dont judge yourself. Gently smile and let them float away. Know that what emerges is ready to leave your system. Thats right, all thoughts, beliefs, fears, emotions, and feelings that surface are actually trying to leave your mind and body, so let them. To help them release, be the witness and observer of what arises and watch it gently float away. Even for the most seasoned meditator, thoughts come up. Its no biggie. Just notice them with curiosity and let them drift away. Then return your attention back onto the guided meditation.

What self-care solutions are available to reduce this harmful distress? Several easy and simple mindfulness meditation techniques can help. You can even do some standing in a checkout line, awaiting the doctor or while sitting in traffic. Along with yoga and repetitive prayer, mindful practices are known to evoke the relaxation response”, which is the counterpart to the stress response. Meditators enjoy greater emotional clarity and mental resilience, and meditation can actually increase the amount of gray matter in your brain (which is a good thing!)

What is MODERN MEDITATION? In todays relentless hyper-speed world of soundbites and snapchats, traditional practices like sitting and meditating for an hour in a quiet room are no longer practical. Modern Meditation reaches more people by adapting traditional meditation techniques to suit the needs and lifestyles of people today.

SCIENCE BACKED RESULTS: Researchers from Johns Hopkins University examined almost 19,000 meditation studies and found 47 trials on stress and anxiety which they deemed well-designed studies.1 The results of this meta-study were published in The Journal of the American Medical Associations Internal Medicine, and suggest that mindful meditation brings calming benefits to psychological stresses like depression, anxiety, and pain. Meditation has been demonstrated to reduce insomnia and help lower blood pressure. The benefits of the relaxation response have also been shown to increase mitochondrial resiliency, which may reduce vulnerability to disease.2

In another study at the University of Maryland, 63 rheumatoid arthritis (RA) patients used mindfulness meditation.3 They reported a 35% reduction in psychological distress and increased sense of well-being after an eight week period of mindfulness.

In the field of psychoneuroimmunology (the study of how the mind affects health and the bodys resistance to disease), research is showing that thoughts influence the immune system, and stress makes you sick.4 If thats compelling enough to motivate you, why not launch a new healthy habit of mindfulness and meditation?

EAST MEETS WEST:  One does not have to sit in a full lotus pose on a Nepalese mountain to meditate or be mindful. Modern Meditation delivers a new approach to meditation based on scientific research by combining Eastern philosophy with Western science. As little as 5 to 10 minutes per day can deliver benefits. Although some meditation techniques, like Transcendental Meditation®, have specific routines – there are no set rules for meditating. The aim is simply to develop present moment awareness.

A variety of meditation apps make it easy, by blending user-friendly technology with meditation techniques. They feature deep breathing or guided imagery to help relax your mind. Using an app for mindfulness makes the process simple, is completely portable and keeps you on track with your practice. One app company, Headspace, is now seeking FDA approval as the first prescription meditation app with clinically validated meditation programs. Its rollout date is 2020.

NO TIME TO BE MINDFUL?  Lets keep it really simple and focus on one form of mindfulness: breathing. Respiration is actually the only automatic body function we can voluntarily control. You can shift into a present moment state of calm quickly and easily by intentionally focusing on your breath. Breath work is the fastest state-changer available, it can soothe your nervous system and deliberately move you from fear to calm.

GET ADDICTED TO THE HEALTHY MED!  Get hooked on meditation, not social media or medication! If you spend a chunk of time immersed in social media feeds every day, why not shift some of that time to receive positive benefits of meditation? Or, the next time you have difficulty sleeping or feel anxious, try five minutes of relaxing breath work to see if that helps. Its easy to get started by adding present moment awareness to your life. Building a mindful breathing practice into a meditation practice can be a simple as establishing a small, manageable routine and expanding it as you become comfortable.


Friday, August 26, 2022


Introducing the experience-based review and observational case study of Dr. Leslie Valle of Santa Barbara, CA.  Dr. Valle is the clinical director of BIOMED LIFE, a comprehensive integrative medical program comprised of biological, energy and lifestyle medical practice.  Dr. Valle incorporates her fundamental medical training and expanded knowledge in advanced healing arts including a Cancer Wellness and Chronic Disease program in support of helping people activate their own healing mechanism.  Her avid research in modern modalities and alternative innovations led to the implementation of binaural beats and blue/red light therapy- elements she found efficacious in a device called "BrainTap".

Dr. Leslie Valle / Edited by: Dr. Roberta Kline

Most people have two underlying health issues as a common denominator, sleep deprivation and stress management. Sometimes this comes hand-in-hand with one another.  If we allow it to control our lives, stress can become a silent killer.  This is why as an initial consultation I make sure I get an analysis of everyone's heart rate variability (HRV).  I prefer to have a measurement of function and dysfunction before I read patients complaints and concerns, so I can scientifically show patients their levels of stress, sleep health and brainwave patterns.  The majority of the population firmly believes stress is present in their day-to-day life but never plays a dominant role.  I’ve had patients tell me they are not that much stressed - just “normal” stress.  Until I show them their own HRV analysis, at that point they have acknowledged they adapted to their level of stress and they believe it's normal. 


Lack of quality sleep (7-8 hours of sleep) contributes to the following:

    - Weight gain
    - Brain dysregulation
    - Diabetes
High blood pressure
    - a
nd the possibility of increase risk of cancer

If we don’t sleep we can’t regenerate.  Quality sleep allows our bodies to restore, regenerate and recharge.  And the solution should not push patients to seek more medication.  The answer is binaural beats.  Unlike meditation apps, binaural beats produce brainwave training without discipline effort.  Most of us don’t know how to meditate and with the use of BrainTap we can begin to experience the benefits of meditation; which improves energy levels, memory, quality sleep and a boost in their parasympathetic state (where we rest, recover, rebuild, restore and heal).  Not all mediation apps have the neuroscience technology that BrainTap can offer. BrainTap relies on four key elements that enable the sessions to induce brainwave training: Binaural beats, guided visualization, 10-cycle holographic music and isochronic tones.  The overall goal with the use of binaural beats is to decrease stress and improve your sleep quality.

A potential remedy for loss of sleep: I used to work night shifts and I was always concerned that I would never recuperate from those sleepless nights.  Many of us suffer from sleepless nights; whether it is from jet lag or late night study hours in college or suffering from a chronic disease or simply being under constant stress - now we have a tool to help us have better sleep health.  And the solution is a drug-free treatment called Binaural Beats.

One thing I ask from patients is commitment and patience. Patients have noticed it took more than one session to get used to guided meditation and dual voice.  But with patience and commitment, users have learned to love BrainTap and found it to be easily accessible to add it as part of their healing modalities.  Here, I present 3 cases of how I was able to measure before and after in patients with the use of BrainTap.

CASE EXAMPLE 1: Managing Stress

A 67 year old female was referred for stress management late January. Her stress index was over the normal range and she was aware of it but not to the extent that she could visually see it graphed in front of her. Her heart rate variability analysis showed dominance in sympathetic nervous system, sleep patterns disturbed; high percentages in Delta brain wavelength and her biological age reading her only one year younger to her actual age.  My main focus to help her regulate and manage her stress was to help her build her nonexistent brain wavelengths. For the following 6 months she learned to change her lifestyle but implemented fasting once a week, the use of PEMF therapy  and the use of binaural beats to help manage her stress levels.  She was aware that stress will always be present in her line of work at this stage in her career but learned how to manage it.  She used binaural beats four times a week and learned to love guided meditations.

At her six month consultation and after the use of binaural beats 3-4 times a week her HRV analysis brought much relief to her mind.  Her stress index lowered 70 points and her sympathetic nervous system was reduced back to normal. Her brain entrainment was regulated and her biological age was now reading her a young 53 year old. She was ecstatic to see with the simply use of binaural beats and without medication she was able to bring her body out of adrenal fatigue and able to regulate and manage her stress.

CASE EXAMPLE 2PTSD / Cancer Diagnosis

87 year old female with cancer diagnosis and PTSD along her lifetime presented in a hopeless state to help diminish her stress levels.  Her HRV analysis showed poor regulation, psychoemotional stress present and a biological age of 96.  She understood having a cancer diagnosis did not help alleviate the sense of pending doom of end of life.  

After one short month of daily sessions with PEMF and Binaural beats, not only did her stress levels reduce 500 points but her biological age reversed to 84 years of age.  She knew a shift had occurred in her biology and her psychoemotional state but was also excited to feel the beautiful side effects of binaural beats of regulating her sleep health.  

She continues to thrive and build courage in my practice as she turned 88 this year going on 80.  She happily drives herself to my office for daily sauna and cold plunges.  She wants to make sure she stays youthful and able to maintain the stresses of life in a tolerable state that we can’t avoid. but only learn to manage. 


CASE EXAMPLE 3: Alopecia

56 year patient began her consultations in desperate help in stress management.  She began losing her hair 4 months ago and believes her biggest common denominator is stress related.  Her HRV not only showed off the charts stress index but non-existent neurohormonal levels, low brain wavelengths and a biological age of 69 years of age.  She was terrified with the analysis but not surprised.  She continued her sessions for adrenal support, stress management and brain entrainment.  She was not a big fan at first of BrainTap as she learned to let go and listen.  Her daily  sessions and commitment help fell in love with the voice on the other side of the binaural beats.  


In four months her stress levels were manageable as her stress index decreased into the normal range (10-100), her energy resources were abundant and her biological age decreased from 69 to a healthy 45 year old. She was very pleased to see the drastic change with the use of BrainTap in combination with Ondamed.  She can now manage her stress and can focus on working on her sleep health.

Another common advantage to this energy therapy is managing ANXIETY within the younger generation. I've seen a lot of teenagers in my office recently for just anxiety purposes, which I think has been amplified during this recent era. To introduce the BrainTap device while on an infrared bed, or sitting in ONDAMED® session has opened up that possibility that they can be able to manage their anxiety, which is sometimes not easy to do with a counselor or a psychologist.   The use of BrainTap has been extremely beneficial for the young population. There are numerous ways to incorporate different methods of biohacking your mind and body into your daily routine. (See complete article)

Disclaimer: The information (including, but not limited to text, graphics, images and other material) contained in this article is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or scientific claims. Furthermore, any/all contributors (both medical and non-medical) featured in this article are presenting only ANECDOTAL findings pertaining to the effects and performance of the products/technologies being reviewed - and are not offering clinical data or medical recommendations in any way. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, never disregard professional medical advice or delay in seeking it because of something you read on this page, article, blog or website.

Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (The NY Cancer Resource Alliance/IntermediaWorx inc. and The AngioFoundation). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Sunday, April 17, 2022


Written by:  Robert L. Bard, MD  |  Lennard M. Gettz, Ed.D |  Noelle Cutter, PhD   | Josh T. Schueller, PT

Since the advent of ultrasound scanning in the 1950's, the global movement to develop and expand its diagnostic features continue in its appeal with the medical community today.  The ultrasound design use of sound waves and echo reflection became widely accepted for being the safe (non-radiation), inexpensive, repeatable and non-invasive alternative in medical imaging.  Early clinical upgrades included the development of the pulse Doppler paradigm (1966) to enable scanning layers of the heart via blood flow. This offered diagnostic advantages to its application in the mid-seventies for live-action scans of the human fetus. These qualities earned its place as the standard in pediatric use while continuing to earn the confidence of radiologists and imaging specialists for a wide range of diagnostic applications from emergency critical care to supplemental cancer screening. 


From an interview with Maty Torres, BHSc, RVT

In our ongoing study of non-invasive diagnostic modalities, we connected with Chief Vascular Technologist & Technical Director of Cooperman Barnabas Medical Center's (CBMC) Non-Invasive Vascular Lab, Ms. Maty Torres.  Her vast experience on the use of the Transcranial Doppler provided extensive insight on its many advantages in patient care for both Radiology and Vascular units.

As a career technologist, Ms. Torres started in vascular sonography (1990) then received her first exposure to the field of TCD scanning 1998. In the early part of her tenure, she performed Transcranial Doppler Imaging on a patient population from the Valerie Fund Children’s Center  (A NJ based non-profit group providing support for the comprehensive health care of children with Cancer and blood disorders) for pediatric sickle cell patients. By 2011 her expertise with cerebral doppler scanning were called to new challenges.

As a team-supporting service, Ms. Torres advanced to the next stage of TCD utility in non-imaging TCD exam where this protocol provided great data-gathering advantages in emergent and post-surgical cases for medical collaboration between residents and neuro specialists by monitoring subarachnoid hemorrhage patients for new onsets of vasospasm in Neuro ICU cases. She expresses the major LEARNING CURVE behind being proficient at operating TCD scanning. "This is not a test that you could cross train in a short period and perform it adequately.  Without an image for guidance, you are using audible sounds, waveforms, and direction of flow, thus relying on the technologist’s expertise to find the correct arteries. I have seasoned technologists that range from 11 to 20 years of experience in the field; however, only few perform this study because it’s very specific.”  

Ms. Torres adds, “When a patient is admitted with a subarachnoid hemorrhage, the goal is to search for the source. Some patients might require Endovascular Coiling (treatment to block blood flow/bleeding throughout the body) and recover in the Neuro ICU.  We support the neuro team by providing scheduled monitoring by daily TCD’s evaluating increases in ratios that could detect an increased risk of an onset of vasospasm." 

Her facility currently uses the Nicolet® SONARA® TCD system.  While these hospital-grade devices can be used for Emboli detection or interoperate scanning for PFO (Patent Foramen Ovale) closures, Ms. Torres' current assignments are primarily focused on neuro-monitoring for the detection of increased risks of vasospasms. As a seasoned technical expert in various levels of TCD field use, Ms. Torres shares field insight on the medical applications of this diagnostic protocol. "I see an opportunity to use TCD for patients with symptomatic carotid stenosis at our facility.”  

Her training on TCD imaging first started in 2001 with an intensive training course presented by Medical College of Georgia School of Medicine led by Dr. Robert J. Adams currently at the Medical University of South Carolina working directly on Sickle Cell patients. Dr. Adams is considered a pioneer in using transcranial doppler (TCD) and transcranial Doppler imaging (TCDi) to assess stroke risk in children with sickle cell anemia (SCA). He also helped discover that regular blood transfusions can reduce strokes by as much as 90 percent in these children.[4] Additional training came from Natus training experts who come from many areas such as the Swedish Institute of Neurology and a comprehensive text: Practical Guide to Transcranial Doppler Examinations by Dr. Andrei Alexandrov.

Maty Torres
, BHSc, RVT, Chief Vascular Technologist/Technical Director, Non-Invasive Vascular Lab.  Seasoned Vascular Technologist with a demonstrated history of working in the hospital and health care industry. Skilled in Vascular Sonography, Data Analytics, Health Informatics, and Peer Mentoring. Strong information technology professional with a B.H.Sc. focused in Health Care Administration from Nova Southeastern University, currently pursuing a Master’s in Business Administration from William Patterson University.

Hemodynamics is defined as the study of blood flow in relation to the status of the circulatory system and homeostatic mechanisms of autoregulation.   Through the monitoring of blood flow, diagnostic analysis can provide many answers to the health and physiological status of the target area scanned as well as cell-level metabolism, the regulation of the pH, osmotic pressure and temperature of the whole body, and the protection from microbial and mechanical harm.[1]   Assessing injuries, inflammation or mutative growths (like cancer tumors), assessment of blood flow provides diagnostic answers about the severity of tissue disorders or tumor malignancy.

The expansion of ultrasound research and development broke new ground in 1982 when Dr. Rune Aaslid (Norwegian Neurosurgical researcher) first introduced Cerebral Hemodynamics with the implementation of Transcranial Doppler science to offer noninvasive transcranial recorded imaging of flow velocity in basal cerebral arteries.  His report detailed that placing an accurately configured Doppler ultrasound transducer in the temporal area (just above the zygomatic arch)offers quantitative data of the blood flow velocity in the middle, proximal anterior and posterior cerebral arteries.[1.2] This scan is critical for detecting vasospasms and for reviewing circulation in the brain for potential disease of the carotid and vertebral arteries. [1.5] 

In 1989, Dr. Aaslid published the first study on dynamic cerebral autoregulation in humans - a biological and metabolic function dedicated to stabilizing cerebral blood flow. TCD detects the slightest change in perfusion-- the volumetric measure at which blood is delivered to tissue, or volume of blood per unit time per unit tissue mass. Alongside the study of blood pressure, Cerebral Autoregulation is vital to maintaining life as it supports proper delivery of adequate oxygen (in the blood) and nutrients to the brain and the removal of CO2 & other waste products.[2]  As Dr Aaslid used the TCD by scanning through the transtemporal approach, others explored the intracranial arteries through the orbital (eye socket) window. By the early 90's, the next generation of development teams (Spencer, Seidel, Dobson & Moehring) improved on the Doppler innovation to detect microemboli and hemodynamic physiology. Today, TCD is widely accepted and utilized for an expanding set of clinical and research applications including  ischemic stroke, sickle cell disease, subarachnoid hemorrhage and vasospasm. 

According to cancer diagnostic imaging expert Dr. Robert Bard, the introduction of 4D Doppler technology aligned with the ultrasound's base design concept of providing instantaneous, real time readings.  "Let's take the case of breast cancer screening, the technician simply puts the probe on the breast, finds the area, pinpoints it, presses a button and seconds later you have the map showing the types of vessels, volumetric arterial density and spatial location of the vessels in relation to the adjacent organs. You have functions that give you a vessel density measurement which shows how aggressive this is. Instead of genetic markers (which are very popular), visually displaying tumor aggression  performed in a matter of seconds to show cancer vessel invasion is a game-changer for any early detection or monitoring facility. Tumor aggression by blood flow evaluation is used worldwide in nuclear medicine, CT scans and MRI technology, however, one of the simplest and most cost-effective alternatives is the non‐invasive 3D Doppler breast procedure."

In 1982, continued advancement led to the Transcranial Doppler (TCD) ultrasonography for outpatient and inpatient settings. By integrating the ability to study BLOOD FLOW into a low-frequency transducer, placing the probe on the temporal area measures the cerebral arteries to detect and quantify cerebrovascular activities, diseases and brain injuries.   Other applications include the diagnoses of vasospasm (VSP) after an aneurysm rupture, hemorrhage or hemodynamic changes after ischemic or cryptogenic stroke. It also enables the study of cranial pressure fluctuations.  TCD also offers significant clinical benefits in the monitoring of sickle-cell disease by scanning brain stem death and elevated raised intracranial pressure (ICP).  Added features allow for surgical and post-op monitoring of vasomotor functions as well as detecting critical disorders like a microembolism.

•    Vasospasm /aneurysm
•    Sickle cell anemia, to determine a patient's stroke risk
•    Ischemic stroke
•    Intracranial stenosis/ blockage of the blood vessels
•    Cerebral microemboli


By: Robert L. Bard, MD  and Dr. Pierre Kory, MD

Early detection and prevention of arterial and venous disease is key to minimizing the effects of arterial obstruction & hemorrhage, brain aneurysms, and strokes from venous thrombosis.  The association of trauma to PTSD is now followed by advanced Doppler ultrasound and functional MRI. This abnormal physiology may also manifest as arterial dissection, collagen disease, inflammatory arthritis, dermatitis, ocular disorders, GI disturbances, limb pain, aneurysms of the brain and aorta. Devastating strokes in the Covid-19 era occur in the younger age group and the Latin population who are at higher risk.

Interest in arteritis was elevated with the study of Tayakasu’s disease in the 1970's when advances in contrast arteriography diagnosed diffuse vascular involvement causing strokes and aneurysms in multiple sites. While this arterial inflammation is more common in Asians, in the US, blacks are nearly three times more likely to have a stroke at age 45 than whites. The pediatric population seems to be at higher risk for this arteritis as evidenced by their unusual rate of Covid-19 affliction affecting the vasculature and called “MULTIPLE ACUTE INFLAMMATORY SYNDROME“.  Birth control pills is a distinct cause of such disease in younger women while cancer, alcoholism and obesity raise the incidence at all ages. [3]

We have learned over the last century that blockages of coronary arteries to the heart and carotid arteries to the brain are precipitated by inflammation of the inner walls of the vessel, called the “intima”

While thickening of the interior wall of vessels gradually occurs over time and is aggravated by diet, stress and hypertension (high blood pressure), the acutely disabling event occurs when there is an abrupt tear of the overlying plaque which ruptures debris which then forms a blood clot which blocks blood flow or the clot travels deeper into the brain and blocks blood flow. Similarly, abnormal heart rhythms such as “atrial fibrillation”, causes the pooling of blood in the heart which predisposes to clot formation and the clots can then travel into the brain causing a stroke. In Covid-19, the virus causing severe inflammation in the blood which then promotes clot formation which can travel through the vascular system and affect almost every organ system in the human body, with the brain and lungs being the most vulnerable. An article in September NEUROLOGY reported by Medscape documented the incidence of large artery stroke as the presenting symptom of COVId-19 was highest in men under the age of 50 years.  [4]

A medical research team at Metropolitan Hospital in New York first noticed unusual neurologic symptoms in young and middle aged patients in the late 1960s. As a division of the NY Medical College system, they were fortunate to have an active interventional radiology department specializing in neuroimaging and arteriography. The observation of distortion and occlusion of arteries supplying the brain, kidneys, GI tract and lower limbs to various degrees from single to multiple locations was closely linked to the Japanese disorder known as Tayakasu’s arteritis at the time and recently renamed “arteritis.” A clinical finding of this arterial inflammation in the abdominal aorta was pain in the upper abdomen by the great vessels by palpation. Astute physicians were successfully treating this with commonly available “aspirin.”

However, the chronic and diffuse nature of arteritis often weakened the vessel wall producing aneurysmal dilation and rupture. Today we find sophisticated non-invasive or minimally invasive modalities to be the first line of interrogation of vasculitis. [5]

COVID-19 was rapidly understood as a disease caused by severe and widespread inflammation and “hypercoagulability” (a tendency to spontaneously form clots in the blood vessels.) Autopsies have revealed extensive small vessel strokes, with such strokes often occurring despite aggressive blood thinner treatment and regardless of the timing of the disease course, suggesting that it plays a role very early in the disease process. In one autopsy series, there was a widespread presence of small clots with acute stroke observed in over 25%. In a recent review of the incidence of stroke in COVID-19, almost 2% of all hospital patients suffered a stroke, which is 8x higher than in patients with influenza. More worrisome is that this is almost definitely a gross underestimate given the many likely missed strokes in patients who died on ventilators who were too ill to obtain imaging, the general restrictions on and lack of autopsies, and the well-recognized decrease in the number of patients with acute stroke symptoms seeking medical attention in the COVID-19 era.  Another worrisome finding from a recent study of COVID-19 cases found that 45.5% of patients reported neurologic symptoms [6,7]. This under-recognized epidemic of neurological symptoms and strokes in COVId-19 highlights the need for more intensive imaging and investigation to achieve not only earlier recognition and improved treatment of patients but in furthering understanding of COVID-19 effects on brain function.

Blood flow abnormalities in the arterial system are best study by Doppler imaging like the weather Doppler showing tornadoes. Multiple options exist for blood flow analysis including:

- Carotid Sonogram
- Carotid Doppler
- Eye Sonography
- Transorbital Doppler
- Contrast Enhanced Ultrasound
- Transcranial Doppler
- Hybrid Imaging
- 3D/4D Vessel Density Histogram
- Endoarterial 3D Doppler
- Retinal OCT
- Soft Tissue OCT
- Reflectance Confocal Microscopy
- Small Coil MRI
- 7 Tesla MRI

CAROTID SONOGRAM: While cerebrovascular disease is often diagnosed ex post facto after a catastrophic episode with MRI and CT, the non invasive Doppler analysis of the vascularity is generally checked with ultrasound for plaque and obstruction. A useful measure of the risk of coronary and cerebrovascular disorder is the carotid intimal thickness (CIMT). Standard depth of the inner wall thickness is a measure best obtained by high resolution sonograms since a reading over 0.9mm indicates increased risk. The newer sonogram units have depth resolution of 0.02mm making this a preferred non invasive option.


- COLOR DOPPLER - most common application where red is flow towards the probe and blue is flow away from the probe
- POWER DOPPLER - higher spatial resolution without directional flow correlation
3D POWER DOPPLER - allows volumetric analysis of vessel density used in treatment correlation where more vessels means increased neovascularity and fewer vessels correlates with clinical improvement
- ANGIODOPPLER – similar to color Doppler with higher spatial resolution
MICROVASCULAR DOPPLER-images capillary flow
B-FLOW DOPPLER-not true flow technology but observes motion of red blood cells directly

CAROTID DOPPLER: Flow abnormalities of turbulence and absence are commonly evaluated with this modality. Plaque forms more readily in aberrant flow patterns and high velocity regions accompanying narrowing.

EYE SONOGRAPHY: Sonofluoroscopy of the orbital soft tissues and eyes is performed in multiple scan planes with varying transducer configurations and frequencies. Power and color Doppler use angle 0 and PRF at 0.9 at optic nerve head. 3D imaging of optic nerve and carotid, central retinal arteries and superficial posterior ciliary arteries performed in erect position before and after verbal communication. Retinal arterial flow is measured. Optic nerve head bulging is checked as increased intracranial pressure may be demonstrable.

TRANSORBITAL DOPPLER: R/L ciliary arteries have normal Doppler flows of 10cm/s which is symmetric.

CONTRAST ENHANCED ULTRASOUND: Widely used European nonionic contrast injection allows imaging capillary size vessels and perfusion characteristics

TRANSCRANIAL DOPPLER: This measures the flow in the anterior, middle and posterior cerebral arteries as well as Circle of Willis.

3D/4D VESSEL DENSITY HISTOGRAM: Multiple image restoration and reconstruction shows retinal vessel density of 25% at the optic nerve head and adjacent region with quantitative accuracy.[8]

ENDOARTERIAL 3D DOPPLER: Microcatheters inserted into the arterial or venous system provide measurement of wall thickness and presence of inflammatory vessels inside the intima.

RETINAL OCT: Subtraction techniques done with OCT optical coherence tomography may show changes in the caliber of the retinal vessels with verbal ideation.

SOFT TISSUE OCT: The depth of penetration may be extended to 2-3mm allowing for analysis of vascular changes in erythematous or erythropoor dermal areas. Thrombosis may be observed.

REFLECTANCE CONFOCAL MICROSCOPY: This microscopic analysis of the cells also quantifies microvascular pathology and is a potential modality for studying vasculitis.

SMALL COIL MRI: High resolution systems used for animal study and superficial organs can image the intra-arterial anatomy including dynamic contrast imaging on standard 1.5T and 3T units.

7 TESLA MRI: High field systems analyze signal abnormalites rapidly with high resolution.

HYBRID IMAGING: Hybrid imaging refers to combining diagnostic modalities to assess disease and monitor therapy. 

Disclaimer: The information (including, but not limited to text, graphics, images and other material) contained in this article is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or scientific claims. Furthermore, any/all contributors (both medical and non-medical) featured in this article are presenting only ANECDOTAL findings pertaining to the effects and performance of the products/technologies being reviewed - and are not offering clinical data or medical recommendations in any way. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, never disregard professional medical advice or delay in seeking it because of something you read on this page, article, blog or website.


1) Hemodynamics:


3). Hassani SN, Bard RL: Ultrasonic Diagnosis of  Aortic Aneurysms. J. Natl. Med. Assoc. 66:298-299, July 1974

4). Lande A, Bard RL: Arteriography of Pedunculated Splenic Cysts. Angiology 25:617-621, October 1974

5). Lande A, Bard RL, Rossi P: Takayasu's Arteritis: A World Entity. N.Y. State J. Med. 76:1477-1482, Sep 1976

6). Helbick Eur Radiol 30:5536-5538, 2020

7). Mao l  JAMA Neurol 2020 77:683-690

8). Bard RL , Gettz L, van der Bent S etal: Proceedings of the 4th Inflammatory Disease Summit at NY Academy of Medicine  Nov 2021