Diagnostic Ultrasonography in Neurology

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Neurociências Clínicas e Saúde Mental

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Ultrasonography allows neurologists to complement clinical information with additional useful, easily acquired, real-time data. This article highlights its clinical applications in neurology.</jats:p> </jats:sec> <jats:sec> <jats:title>LATEST DEVELOPMENTS</jats:title> <jats:p>Diagnostic ultrasonography is expanding its applications with smaller and better devices. Most indications in neurology relate to cerebrovascular evaluations. Ultrasonography contributes to the etiologic evaluation and is helpful for hemodynamic diagnosis of brain or eye ischemia. It can accurately characterize cervical vascular atherosclerosis, dissection, vasculitis, or other rarer disorders. Ultrasonography can aid in the diagnosis of intracranial large vessel stenosis or occlusion and evaluation of collateral pathways and indirect hemodynamic signs of more proximal and distal pathology. Transcranial Doppler (TCD) is the most sensitive method for detecting paradoxical emboli from a systemic right-left shunt such as a patent foramen ovale. TCD is mandatory for sickle cell disease surveillance, guiding the timing for preventive transfusion. In subarachnoid hemorrhage, TCD is useful in monitoring vasospasm and adapting treatment. Some arteriovenous shunts can be detected by ultrasonography. Cerebral vasoregulation studies are another developing field of interest. TCD enables monitoring of hemodynamic changes related to intracranial hypertension and can diagnose cerebral circulatory arrest. Optic nerve sheath measurement and brain midline deviation are ultrasonography-detectable signs of intracranial hypertension. Most importantly, ultrasonography allows for easily repeated monitoring of evolving clinical conditions or during and after interventions.</jats:p> </jats:sec> <jats:sec> <jats:title>ESSENTIAL POINTS</jats:title> <jats:p>Diagnostic ultrasonography is an invaluable tool in neurology, used as an extension of the clinical examination. It helps diagnose and monitor many conditions, allowing for more data-driven and rapid treatment interventions.</jats:p> </jats:sec>

Keywords

• Foramen Ovale, Patent; Humans; Intracranial Hypertension; Neurology; Subarachnoid Hemorrhage; Ultrasonography, Doppler, Transcranial; botulinum toxin; acute ischemic stroke; aortic valve disease; arteriovenous fistula; arteriovenous malformation; arteriovenous shunt; arteritis; artery dissection; artery steal syndrome; atherosclerosis; atherosclerotic plaque; autoregulation; B scan; blood clot lysis; blood flow velocity; brain death; brain ischemia; brain vasculitis; brain vasospasm; carotid artery; carotid artery occlusion; carotid endarterectomy; cerebral autoregulation; cerebral vasoreactivity; cerebrovascular accident; clinical evaluation; clinical examination; coronary hemodynamics; cranial neuropathy; diagnostic test; Doppler ultrasonography; dural arteriovenous fistula; echography; embolism; eye ischemia; fibromuscular dysplasia; fistula; headache; heart right left shunt; heart septum defect; hemodynamic monitoring; hemodynamic parameters; human; inflammation; intracranial arter