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Neurovascular ultrasound in emergency settings: diagnostic and therapeutic aspects

T. Santos, M. Veloso, P. Barros [REV NEUROL 2017;64:367-374] PMID: 28368084 DOI: https://doi.org/10.33588/rn.6408.2016428

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Volumen 64 | Number 08 | Nº of views of the article 10.201 | Nº of PDF downloads 347 | Article publication date 16/04/2017

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ABSTRACT

INTRODUCTION Neurovascular ultrasound is a non-invasive, portable and fast imaging method that, when performed by an experienced neurosonologist, offers reliable and reproducible information on the morphological and hemodynamic status of cervical and intracranial vessels.

AIM To review the available evidence regarding the use of this tool in the approach to acute stroke. DEVELOPMENT. Neurovascular ultrasound can be used in one of two ways: diagnostic and therapeutic. Considering the low recanalization rates of internal carotid artery and proximal medial cerebral artery occlusions with intravenous recombinant tissue plasminogen activator (r-tPA), neurovascular ultrasound used shortly in Emergency Department may help to select patients that could benefit from endovascular therapy. Moreover, ultrasound monitorization during intravenous r-tPA treatment allows the analysis of the pattern of arterial recanalization. Cervical ultrasound allows the assessment of the stenosis degree and the composition/surface of an arterial plaque that could, for instance, reveal earlier a candidate for carotid intervention. Finally, the therapeutic potential of ultrasound is also being investigated. Sonothrombolysis and sonolysis, that combine ultrasound technology with r-tPA and use exclusively the ultrasound to lyse the clot, respectively, showed promising results. CONCLUSION. Neurovascular ultrasound has greatly expanded to assume an important role in the study of cerebrovascular disorders. KeywordsBrain ischemia Cerebral arteries Cerebral infarction Endovascular procedures Stroke Ultrasonography CategoriesPatología vascular Técnicas exploratorias

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Neurovascular ultrasound in emergency settings: diagnostic and therapeutic aspects

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