Neuro-ultrasonography - 21/11/19

Doi : 10.1016/j.ncl.2019.09.006

Ryan Hakimi, DO, MS, FNCS, NVS ^a,^⁎ , Andrei V. Alexandrov, MD, RVT ^b, Zsolt Garami, MD ^c,^d
^a Director, Neuro ICU, Inpatient Neurology, and TCD Services, Greenville Memorial Hospital, Prisma Health-Upstate, University of South Carolina School of Medicine-Greenville, 200 Patewood Drive, Suite B350, Greenville, SC 29615, USA
^b Department of Neurology, The University of Tennessee Health Science Center, 855 Monroe Avenue, Suite 415, Memphis, TN 38163, USA
^c Institute for Academic Medicine, Research Institute, Houston, TX, USA
^d Vascular Ultrasound Laboratory, Houston Methodist Hospital, Weill Cornell Medical College, 6550 Fannin Street, Suite 1401, Houston, TX 77030, USA

^∗Corresponding author.

Resumen

Transcranial Doppler ultrasonography (TCD) is a noninvasive, bedside, portable tool for assessment of cerebral hemodynamics. Modern TCD head frames allow continuous hands-free emboli detection for risk stratification and assessment of treatment efficacy in several cardiovascular diseases. Identifying a focal stenosis, arterial occlusion, and monitoring the treatment effect of intravenous tissue plasminogen activator can easily be accomplished by assessing TCD waveforms and determining prestenotic and poststenotic mean flow velocities. TCD is an excellent screening tool for vasospasm in aneurysmal subarachnoid hemorrhage. The use of intraoperative TCD during carotid endarterectomy and stenting allows optimal intraoperative hemodynamic management. Other applications are also discussed.

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Keywords : TCD, Transcranial Doppler ultrasonography, Vasospasm, Neurosonology, Subarachnoid hemorrhage, Neurocritical care, Optic nerve sheath diameter, Emboli detection