Advances in transcranial doppler ultrasonography |
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Authors: | Georgios Tsivgoulis Andrei V Alexandrov Michael A Sloan |
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Institution: | (1) TGH/USF Stroke Program, Department of Neurology, University of South Florida College of Medicine, 2A Columbia Drive, Room 7034, Tampa, FL 33606, USA |
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Abstract: | Transcranial Doppler ultrasonography (TCD) is the only noninvasive real-time neuroimaging modality for the evaluation of characteristics
of blood flow in basal intracerebral vessels that adds physiologic information to structural imaging. TCD has been rapidly
evolving from a simple noninvasive diagnostic tool to an imaging modality with a broad spectrum of clinical applications.
In acute stroke, TCD can provide rapid information about vascular stenosis and occlusion, the hemodynamic status of the cerebral
circulation, and real-time monitoring of recanalization. Extended applications such as vasomotor reactivity testing, emboli
monitoring, and right-to-left shunt detection help clinicians ascertain stroke mechanisms at the bedside, plan and monitor
treatment, and determine prognosis. In the neurointensive care unit, TCD is useful for detecting increased intracranial pressure
and confirming cerebral circulatory arrest. TCD is of established value for screening children with sickle cell disease and
detecting and monitoring vasospasm after spontaneous subarachnoid hemorrhage. |
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