Introduction of an embolus detection system based on analysis of the transcranial Doppler audio-signal.

A new embolus detection system (EDS) is presented, built with the intention of detecting ongoing cerebral embolization in patients at risk of transient ischaemic attacks or stroke. It is based on the analysis of the audio-Doppler signal of a transcranial Doppler machine. The algorithm of the EDS estimates the intensity, duration and zero-crossing dynamics of the audio signal. The EDS has a multi-layer neural network which classifies events into micro-emboli signals (MES) or artefacts. The decision-making component of the software has been validated against human experts. Data from patients in the post-operative phase of carotid surgery were used for the validation process. The results showed agreement in MES and artefact classification of > 93%. Apart from a monitoring display, the monitoring system includes a verification unit that allows the user to listen and to look at all data of individual MES and artefacts. Moreover, the system allows the user to record, store and re-calculate all data files. Data are stored using European Data Format, which allows data transportation over the Internet. The EDS may have a potential in stroke risk stratification, evaluating the effect of novel anti-thrombotic therapies, and in peri-operative and remote monitoring of carotid endarterectomy.

[Brain injury in boxers and soccer players; an advisory report from the National Health Council of the Netherlands]. / Hersenletsel bij boksers en voetballers; een adviesrapport van de Gezondheidsraad.

The National Health Council of the Netherlands has released a report entitled 'Brain damage in boxers and soccer players'. It examines epidemiology and prevention of cerebral damage from professional and amateur sports, focusing particularly on soccer and boxing. The connection between cerebral injuries and acute and chronic sports injuries is well established. However, proper diagnosis and therapy may be difficult in acute head trauma and during the chronic stage. It makes proposals for a simple cognitive screening test for acute injuries (soccer-related in particular) and more extensive testing for the detection and follow-up of chronic cerebral injuries (boxing-related in particular). Neuropsychological testing may be an important additional diagnostic tool. Professional boxing should be banned if the measures suggested fail to prevent chronic cognitive dysfunction. A dedicated knowledge centre for soccer and boxing would enhance the epidemiology and knowledge of brain injuries, and could help to develop more evidence-based guidelines in the future.