Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) tr...Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called "paradoxical embolism", most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called "microembolic signal grading score". In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.展开更多
隐源性卒中是指通过常规检查不能明确病因的缺血性卒中.随着医学技术的发展,研究发现大部分隐源性卒中由栓塞所致,故提出了栓子源不明的栓塞性卒中（embolic stroke of undetermined source,ESUS）的概念.ESUS的病因主要包括亚临床心房...隐源性卒中是指通过常规检查不能明确病因的缺血性卒中.随着医学技术的发展,研究发现大部分隐源性卒中由栓塞所致,故提出了栓子源不明的栓塞性卒中（embolic stroke of undetermined source,ESUS）的概念.ESUS的病因主要包括亚临床心房颤动、卵圆孔未闭、主动脉弓粥样硬化斑块、非狭窄性复杂性颈动脉粥样斑块和肿瘤相关性栓塞等.文章就ESUS的病因和二级预防进行了综述.展开更多
矫正型大动脉转位(corrected transposition of great arteries,CTGA)是一种罕见的复杂性先天性心脏病,占先天性心脏病的0.4%~1%[1-2]。有研究表明,80%~95%的CTGA患者内脏正位,5%~20%存在内脏反位[3]。本例患者CTGA合并内脏反位,同时存...矫正型大动脉转位(corrected transposition of great arteries,CTGA)是一种罕见的复杂性先天性心脏病,占先天性心脏病的0.4%~1%[1-2]。有研究表明,80%~95%的CTGA患者内脏正位,5%~20%存在内脏反位[3]。本例患者CTGA合并内脏反位,同时存在卵圆孔未闭(patent foramen ovale,PFO),并发生脑梗死。对于这一特殊类型的患者,临床该如何处理?展开更多
文摘Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called "paradoxical embolism", most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called "microembolic signal grading score". In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.
文摘隐源性卒中是指通过常规检查不能明确病因的缺血性卒中.随着医学技术的发展,研究发现大部分隐源性卒中由栓塞所致,故提出了栓子源不明的栓塞性卒中（embolic stroke of undetermined source,ESUS）的概念.ESUS的病因主要包括亚临床心房颤动、卵圆孔未闭、主动脉弓粥样硬化斑块、非狭窄性复杂性颈动脉粥样斑块和肿瘤相关性栓塞等.文章就ESUS的病因和二级预防进行了综述.
文摘矫正型大动脉转位(corrected transposition of great arteries,CTGA)是一种罕见的复杂性先天性心脏病,占先天性心脏病的0.4%~1%[1-2]。有研究表明,80%~95%的CTGA患者内脏正位,5%~20%存在内脏反位[3]。本例患者CTGA合并内脏反位,同时存在卵圆孔未闭(patent foramen ovale,PFO),并发生脑梗死。对于这一特殊类型的患者,临床该如何处理?
