Neurosonology for Unconscious or Neurocritically Ill Patients
이성준, 안정환, 홍지만,
소속 상세정보
이성준 ( Lee Seong-Joon )
Ajou University School of Medicine Department of Neurology
안정환 ( Ahn Jung-Hwan )
Ajou University School of Medicine Department of Emergency Medicine
홍지만 ( Hong Ji-Man )
Ajou University School of Medicine Department of Neurology
Abstract
Evaluating unconscious patients is a diagnostic and therapeutic challenge for emergency neurology practitioners and critical care neurologists. Although much of the underlying pathology of altered mental status can be life-threatening, it is also potentially reversible with timely interventions. Thus, thorough neurological exams and rapid neurological imaging are needed for accurate diagnosis. Ultrasound is a safe and effective form of imaging that can assist in the diagnostic process as a sole modality if advanced imaging is not available or as an adjunct technique that can provide further information regarding the temporal course of the patient’s condition. In particular, transcranial Doppler ultrasound (TCD) can be used to detect intracranial large artery occlusions and aid in selecting patients eligible for reperfusion therapy. TCD-based information can also be used to monitor vasospasm after subarachnoid hemorrhage. Furthermore, TCD, as well as other forms of ultrasound, can detect increases in intracranial pressure noninvasively. Bedside ultrasound of the cardiovascular and thoracic systems can be also performed in a sequential framework for goal-directed therapy in the neurocritical care unit. In this review, we discuss the use of ultrasound in such situations.
키워드
Ultrasonography, Doppler, Transcranial; Intracranial hypertension; Echocardiography; Point-of-care systems
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