Neurosonological Examinations of Transient Ischemic Attack

Abstract

Cerebrovascular ultrasonography is the only modality that provides real-time information about blood flow in various cervicocerebral arteries. Continuous information can be obtained over extended periods with high resolution and excellent spatial display. Hemodynamic changes in the cerebral circulation due to various physiological or pathological states can be monitored reliably. The information obtained from cerebrovascular ultrasonography carries diagnostic, therapeutic as well as prognostic potential in various conditions. Cervical duplex sonography evaluates blood flow as well as arterial wall characteristics in the major arteries that supply the cerebral vascular bed. Validated criteria for the diagnosis of steno-occlusive disease of carotid or vertebral arteries have high accuracy parameters. Transcranial Doppler (TCD) ultrasonography provides a reliable evaluation of intracranial blood flow patterns in real-time and adds physiological information to the anatomical details obtained from other neuroimaging modalities. Cerebrovascular ultrasonography is relatively cheap, can be performed at bedside, and allows monitoring in acute emergency settings. Extended applications of TCD provide important information about the pathophysiology of cerebrovascular ischemia and risk stratification. Therefore, cerebrovascular ultrasonography has become an integral component of the armamentarium of stroke neurologists for understanding stroke etiopathogenesis, planning and monitoring definitive treatment and determining the prognosis. It has been suggested as an essential component of a comprehensive stroke center. We have reviewed various established applications of ultrasonography in patients with cerebrovascular ischemia.