Türk Beyin Damar Hast Derg. 2012; 18(3): 59-71 | DOI: 10.5505/tbdhd.2012.80775

Neurosonology of emboli detection and monitoring

Mehmet Akif Topçuoðlu, Ethem Murat Arsava
Hacettepe University, Medical Faculty, Neurology Department, Neurosonology Laboratory, Ankara

Cerebral embolism is the leading cause of ischemic stroke. Detection of microembolic signals [MES] in cerebral circulation is uniquely attained by several transcranial Doppler techniques, and can not be obtained with any other available imaging modality. Albeit no uniform picture has emerged from the studies, presence and amount of MES can identify a high-risk status in the setting of potential arterial or cardiac sources of cerebral embolism. Real-time MES monitoring during vascular procedures with high cerebral embolism risk seems also promising. The potential of MES detection in improvement of patient care is usually acknowledged, even though several aspects remain yet to be scientifically established. We herein review theory, technique and clinical potential of the neurosonological emboli detection, and try to add to understanding of the journal readership about the recent development on this subject.

Keywords: transcranial Doppler, microembolic signal, patent foramen ovale, M-mode, multi-gate, robotic ambulatory monitoring

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Emboli saptama ve monitorizasyonunun nörosonolojisi

Mehmet Akif Topçuoðlu, Ethem Murat Arsava
Hacettepe Üniversitesi, Týp Fakültesi, Nöroloji Anabilim Dalý, Nörosonoloji Laboratuarý, Ankara

Serebral embolizm iskemik inmenin en sýk nedenidir. Dolaþýmda mikroembolik sinyal (MES) saptanmasý transkranial Doppler (TCD) dýþýnda hiçbir mevcut teknik ile ulaþýlamayan ve gelecek inme riskini ortaya koymada kritik önemi olduðu hemen her çalýþmada saptanmýþ olan bir yöntemdir. Gerçek zamanlý MES varlýðý semptom durumuna bakýlmaksýzýn yüksek risk statusunu iþaret eder. MES bulunuþuna göre tedavi adaptasyonunun hasta özelinde yararlý olduðu konusu henüz karara baðlanmamýþ olmakla birlikte potansiyelin yüksek olduðu genellikle düþünülmektedir. Bu derlemede nörosonolojik emboli belirleme ve sayýmýnýn teorisi, tekniði ve klinik potansiyeli detaylý olarak ele alýnmaktadýr.

Anahtar Kelimeler: transkranial Doppler, mikroembolik sinyal, patent foramen ovale, M-mod, multi-gate, robotik ambulatuar monitorizasyon

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