engleski

Possibility of neurosonology in clinical evaluation

Neurosonology includes both extracranial and intracranial noninvasive cerebrovascular evaluation. Extracranial color and power Doppler enables information of noninvasive carotid and vertebral artery testing. Informations of intima-media thickness by means of high-resolution ultrasound are available, as well as on carotid and vertebral artery plaques, echogenicity, plaque surfaces and degree of stenosis. The noninvasiveness and time resolution of the measurement enables follow up of atherosclerotic, inflammatory vessel wall diseases and of dissections. Transcranial Doppler (TCD) proved to be a noninvasive, fast and exact diagnostic tool for the evaluation of cerebral hemodynamics, providing numerous informations on cerebrovascular state of the patient. The greatest advantage of TCD is the possibility of time resolution of the measurement, and due to its noninvasiveness, it can be repeated as frequently as needed. The application does not require large sophisticated equipment, which enables easy transport of the TCD, and bedside evaluation of patients. These techniques allow noninvasive evaluation of the extra- and intracranial hemodynamic in symptomatic or asymptomatic patients with known risk factors to assess the impairment of hemodynamic due to extracranial or intracranial large artery arteriosclerosis or advanced cardiac disease. It proved to be an excellent diagnostic tool in stroke prevention in certain hematologic disease. Beside neurovascular disorders it enables insight into cerebral hemodynamic in other neurologic patients like migraine, epilepsy and cognitive disorders. Bedside evaluation is required in all stroke patients giving information of the intracranial hemodynamic in cerebral artery occlusion, and enables monitoring of the recanalization. The evaluation of development of collateral circulation, in atherosclerotic, as well as in dissection or inflammatory disease is possible. In hemorrhagic stroke, vasospasm of the intracranial vessels can be detected, and reliably monitored. In intensive care unites, evaluation of the intracranial pressure can be monitored, as well, as the development of the cerebral circulatory arrest, defining the exact time of the brain death. Monitoring of the cerebral circulation is possible during surgery. Recent TCD modalities enable detection of cerebral microemboli, estimation of cerebral vasoreactivity, and cerebral autoregulation by analyzing cerebral microcirculatory responses after different stimulation tests. Neursonology cover techniques that enable noninvasive and objective diagnostic tool for the assessment of cerebral hemodynamics in patients with cerebrovascular diseases, risk factors for stroke or other neurologic diseases. It is irreplaceable method for stroke classification and monitoring in intensive care units.

neurosonology; transcranial Doppler; CDFI

nije evidentirano