Cerebrovascular Ultrasound in Stroke Prevention and Treatment

Beschreibung

Ultrasound enables us to monitor the cardiovascular system andbrain responses to treatment in real time; a genuine blessing onthe route to more effective stroke therapies, and an invaluabletool with which to tailor treatment when available evidence ismeagre. Ultrasound is a vital observational tool, yet a probe needsa scientist to point it in the right direction and a skilledphysician to synthesise scientific data with practical managementstrategies. This book, intended for clinicians who are eager to learn andprepared to observe, focusses on the examination of strokepatients, the interpretation of ultrasound studies, and theapplication of cerebrovascular ultrasound to management andtreatment strategies. Produced by an international team ofcontributors and edited at the University of Texas, one of themajor world centres in stroke research, it is a practical volumethat can be used by beginners to learn the principles of ultrasoundtesting, by advanced users to learn differential diagnosis, and byclinicians (non-sonographers) who treat stroke patients. The latterwill gain knowledge on how to apply ultrasound, and what to expectfrom it in terms of clinical decision making and treatmentselection.

Autor*in

Andrei V. Alexandrov

Themen in »Cerebrovascular Ultrasound in Stroke Prevention and Treatment«

Medical Science Medizin Ultraschall Ultrasound

Stimmen zu »Cerebrovascular Ultrasound in Stroke Prevention and Treatment«

Review of the textbook "Cerebrovascular Ultrasound in Stroke prevention andTreatment" Edited by Andrei V. Alexandrov Assistant Professor of Neurology and Radiology, Director, STATNeurosonology Service and Center for Non-invasive Brain PerfusionStudies Stroke Program, University of Texas-Houston Medical SchoolHouston Texas First Edition, 2004. 267 pages. Blackwell Publishingwww.blackwellpublishing.com, www.blackwellfutura.com This book has been produced by an international team ofcontributors, edited at the University of Texas and is aimed atthree types of individuals: beginners to learn the basics ofultrasound testing, advanced users to learn differential diagnosisand clinicians involved in treating stroke patients. The text ispacked full of useful practical information and has excellentillustrations and TCD images. However, the content is not basic andbeginners wishing to start TCD would be advised to read simplertexts prior to this book. It is divided into five parts: Part I-Howto perform ultrasound tests covers both extracranial andintracranial ultrasound examination with an emphasis onstandardisation for carotid duplex. The techniques for carrying outsingle-gated spectra (TCD), power-motion Doppler (M-mode) andtranscranial colour duplex imaging (TCCS) are outlined in a simpleand clear manner. The advantages of M-mode (easier window-finding)and TCCS (identifying anomalies of the circle of Willis) for thebeginner are emphasised but the caveat for both M-mode and TCCS isspectral resolution and it is acknowledged that experiencedoperators will still use single-gated TCD. Part II-Haemodynamicprinciples is a "heavy" section but will be ofparticular interest to anyone working in the intensivecare/surgical setting. The chapter on practical models of cerebralhaemodynamics importantly emphasises spectral waveform recognitionrather than the usual emphasis on velocity. Part III-Criteria forinterpretation. is an excellent section covering diagnostic andvalidation criteria for carotid stenosis, carotid and vertebralartery dissection and occlusion, intracerebral arterial vasospasm,embolism detection, with a good description of the TIBI ultrasoundclassification for large vessel occlusion. Part IV-Ultrasoundin stroke prevention and treatment covers ultrasound findings ofspecific diseases including sickle cell disease, cardiovascularrisk, secondary stroke prevention, acute ischaemic stroke,subarachnoid haemorrhage. The chapter on ischaemic stroke discussesthe potential therapeutic use of TCD and is well worth reading.Part V-Select clinical applications and clinical vignettesincludes an interesting collection of anecdotal vascular casescovering areas, which can give diagnostic difficulty. The excitingparts of this book have to be the emphasis on the potentialtherapeutic use of diagnostic TCD and the focus on waveformanalysis rather than velocity measurements. This opens up TCD as abedside tool, which will hopefully mean that more clinicians willstart using this powerful technique. Dr Paul Syme Consultant Physician Lead Stroke Physician NHS Borders Part-time Senior lecturer University of Edinburgh
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