Cerebrovascular Ultrasound in Stroke Prevention and Treatment

Effective stroke therapy can be improved through real-time monitoring of the neurological and cardiovascular responses to treatment. This requires crucial knowledge on behalf of both the sonographer and stroke physician to make the best decisions for the patient so as to minimize the damage caused by the original stroke and the risk of further stroke.

Cerebrovascular Ultrasound in Stroke Prevention and Treatment, Second Edition, takes a practical approach to the examination of patients, the interpretation of ultrasound studies and the application of cerebrovascular ultrasound in the development of management and treatment studies, assisting neurologists, radiologists, and ultrasonographers in stroke therapy.

List of Contributors iv

Preface vi

Foreword viii

Preface to the First Edition ix

Foreword to the First Edition x

Acknowledgment (first Edition) xii

Practice of Ultrasound: An Introduction xiii

Part I How to Perform Ultrasound Tests 1

1 Principles of Extracranial Ultrasound Examination 3
Andrei V. Alexandrov, Alice Robinson-Vaughn, Clotilde Balucani & Marsha M. Neumyer

2 Intracranial Cerebrovascular Ultrasound Examination Techniques 13
Andrei V. Alexandrov, Marta Rubiera, Paola Palazzo & Marsha M. Neumyer

3 Anatomy of the Brain’s Arterial Supply 26
Joel Cure

Part II Hemodynamic Principles 45

4 Integrated Assessment of Systemic and Intracranial Hemodynamics 47
Anne W. Alexandrov

5 Practical Models of Cerebral Hemodynamics and Waveform Recognition 68
Andrei V. Alexandrov

Part III Criteria for Interpretation 85

6 Diagnostic Criteria for Cerebrovascular Ultrasound 87
Georgios Tsivgoulis, Marsha M. Neumyer & Andrei V. Alexandrov

Part IV Ultrasound in Stroke Prevention and Treatment 145

7 Ultrasound in Stroke Prevention: TCD and Sickle Cell Disease 147
Fenwick T. Nichols III, Robert J Adams & Anne M. Jones

8 Cardiovascular Risk Factors and Carotid Ultrasound 158
Tatjana Rundek & Joseph F. Polak

9 Applications of Functional Transcranial Doppler (fTCD) 177
Konstantinos Vadikolias & Georgios Tsivgoulis

10 Transcranial Doppler in the Detection and Quantitation of Patent Foramen Ovale and Other Right-to-Left Circulatory Shunts 187
Annabelle Lao, Cindy J. Fuller & Jill T. Jesurum

11 Ultrasound in Neurocritical Care 198
Andrew D. Barreto & James C. Grotta

12 Cerebral Vasospasm after Subarachnoid Hemorrhage 207
Mark R. Harrigan, David W. Newell & Andrei V. Alexandrov

13 Intra-Operative TCD Monitoring 214
Zsolt Garami & Alan B. Lumsden

14 Intracranial Stenosis 228
Vijay K. Sharma & K.S. Lawrence Wong

15 Ultrasound in Acute Stroke: Diagnosis, Reversed Robin Hood Syndrome and Sonothrombolysis 240
Andrei V. Alexandrov, Robert Mikulik & Andrew Demchuk

16 Ultrasound and Gaseous Microspheres 252
Flemming Forsberg & Andrei V. Alexandrov

17 Neurosonology Pearls 262
Georgios Tsivgoulis, Clotilde Balucani & Vijay K Sharma

Index 275

"This is a one-of-a-kind book dedicated to cerebrovascular ultrasound as an extension of the neurovascular examination. Neurosonology is a very exciting emerging field and this book is well written with excellent illustrations, didactic, and easy and fun to read. . . This is a great contribution to the field of vascular neurology and it will expand and enhance the knowledge of vascular neurosonology, hopefully making it more widely available in clinical practice." (Doody's, 28 October 2011)

Edited by Andrei V Alexandrov, MD, University of Alabama Hospital, Birmingham, AL, USA. Imagine sampling tissues and flow behavior in real time at a rate of 5 thousand a second

This is the power of ultrasound for stroke diagnosis and management. It’s also non-invasive, portable, and versatile. Yet it is a woefully underused modality in stroke medicine.

The second edition of Cerebrovascular Ultrasound in Stroke Prevention and Treatment allows all involved in treating stroke patients to learn how ultrasound can enrich their ability to diagnose, evaluate, and treat stroke. It helps sonographers and physicians understand what information can be gained from ultrasound imaging generally, as well as what is needed for a specific case. The authors present a full overview of the "how"s and "why"s, including:

• The principles of intra- and extra-cranial ultrasound
• Hemodynamic principles
• The criteria of interpretation
• Ultrasound in neurocritical care
• Ultrasound in acute stroke

A final chapter on Neurosonology Pearls provides diagnostic waveforms, images, and practical wisdom on best-practice use of ultrasound for monitoring cerebrovascular disease.

Cerebrovascular Ultrasound in Stroke Prevention and Treatment provides neurologists, radiologists, vascular medicine specialists, and sonographers with the basics for developing the skills needed for truly modern stroke diagnosis and care.

Titles of Related Interest
Intracranial Atherosclerosis
Edited by: Kim, Caplan and Wong; ISBN 978-1-4051-7822-8

Stroke: Practical Management, 3e
Warlow et al.; ISBN 978-1-4051-2766-0

A Primer on Stroke Prevention and Treatment: An overview based on AHA/ASA Guidelines
Edited by: Goldstein; ISBN 978-1-4051-8651-3