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Echography and Doppler of the Brain 2021 ed. [Minkštas viršelis]

Edited by , Edited by
  • Formatas: Paperback / softback, 328 pages, aukštis x plotis: 254x178 mm, weight: 669 g, 123 Illustrations, color; 31 Illustrations, black and white; XXI, 328 p. 154 illus., 123 illus. in color., 1 Paperback / softback
  • Išleidimo metai: 04-Oct-2021
  • Leidėjas: Springer Nature Switzerland AG
  • ISBN-10: 3030482049
  • ISBN-13: 9783030482046
Kitos knygos pagal šią temą:
  • Formatas: Paperback / softback, 328 pages, aukštis x plotis: 254x178 mm, weight: 669 g, 123 Illustrations, color; 31 Illustrations, black and white; XXI, 328 p. 154 illus., 123 illus. in color., 1 Paperback / softback
  • Išleidimo metai: 04-Oct-2021
  • Leidėjas: Springer Nature Switzerland AG
  • ISBN-10: 3030482049
  • ISBN-13: 9783030482046
Kitos knygos pagal šią temą:
The aim of this book is to educate and train practitioners in the safe and professional use of diagnostic ultrasound imaging in the visualization and interpretation of various cerebral conditions not only in neurointensive care, but also in the operating room and, in general, cardiothoracic and neurocritical care settings. It is chiefly intended for anaesthetists and intensivists with a basic knowledge of ultrasound physics, but also for neurosurgeons and neurologists.

All chapters were coordinated by the Editors, with experiences in hands-on courses on Echography and Doppler of the Brain, and prepared by international experts. The book covers from basic principles to estimation of intracranial pressure and cerebral perfusion. The topics cover emergency department and prehospital brain US as part of POCUS and US multiorgan evaluation to general intensive care, neurointensive care and anesthesia, including special populations as pregnant and children and setting as LMIC. Clinical scenarios complete the book.





An innovative and unique guide that equips readers to perform bedside and non-invasive assessments for a range of cerebrovascular diseases.
Part I Technology, Views and Normal Echo Anatomy
1 Principles of Transcranial Doppler Ultrasonography
3(6)
Danilo Cardim
Chiara Robba
1.1 Introduction
3(1)
1.2 Transcranial Doppler Ultrasonography
4(2)
1.3 Transcranial Colour-Coded Duplex Ultrasonography
6(1)
1.4 Final Remarks
7(2)
References
7(2)
2 Basic Anatomy with TCCD and Vessels
9(12)
Pierre Bouzat
Thibaud Crespy
2.1 Introduction
9(1)
2.2 Vascular Anatomy
10(4)
2.2.1 The Circle of Willis
10(1)
2.2.2 Vascular Anatomy Through the Temporal Window
11(1)
2.2.3 Vascular Anatomy Through the Transorbital Window
11(1)
2.2.4 Vascular Anatomy Through the Suboccipital Window
12(1)
2.2.5 Vascular Anatomy Through the Submandibular Window
12(1)
2.2.6 Sonography of Cerebral Veins and Sinus
12(2)
2.3 Brain Anatomy with Ultrasonography
14(4)
2.3.1 Anatomic Landmarks
15(1)
2.3.2 Clinical Implications
16(2)
2.4 Conclusion
18(3)
References
18(3)
3 Windows and the Practical Approach: The MOTOr
21(12)
Aoife Quinn
Andrea Rigamonti
3.1 Introduction
21(1)
3.2 Anatomy Abnormalities
22(1)
3.3 Measurements and Basic Calculations
22(1)
3.4 Setup
23(1)
3.5 The MOTOr Approach
24(5)
3.5.1 Mandibular
24(1)
3.5.2 Occipital
25(1)
3.5.3 Transtemporal
26(2)
3.5.4 Orbital
28(1)
3.6 Troubleshooting
29(1)
3.7 Summary
29(4)
References
29(4)
4 Optic Nerve Sheath Diameter
33(8)
Thomas Geeraerts
Louis Delamarre
Charles-Henri Houze-Cerfon
4.1 Introduction
33(1)
4.2 Anatomical Background
34(1)
4.3 Technology and Methods
34(2)
4.3.1 Technology
34(1)
4.3.2 Methods
34(1)
4.3.3 Normal Views
35(1)
4.3.4 Feasibility and Reproducibility
36(1)
4.4 Limits and Safety Issues
36(1)
4.4.1 Limits
36(1)
4.4.2 Safety
37(1)
4.5 Recent Innovation and Future Perspectives
37(1)
4.6 Conclusion
37(4)
References
38(3)
5 Limitations and Pitfalls
41(10)
Aarti Sarwal
5.1 Introduction
41(1)
5.2 Technical Considerations
42(4)
5.2.1 Acquisition of Images
42(2)
5.2.2 Accuracy of Quantitative Measurements
44(1)
5.2.3 Ultrasound-Related Artifacts
45(1)
5.3 Anatomical Considerations
46(1)
5.4 Clinical Considerations
47(2)
5.4.1 Harmful Effects of Ultrasound Exposure
47(1)
5.4.2 Systemic Factors Related to Patients' Cardiopulmonary State
47(1)
5.4.3 Waveform Analysis in Acute Cerebrovascular Pathology
47(1)
5.4.4 Cerebral Circulatory Arrest
48(1)
5.5 Summary
49(2)
References
49(2)
6 The Minimal, Intermediate, and Advanced Skills: How to Boost Your Competencies
51(14)
Frank A. Rasulo
Nicola Zugni
6.1 Introduction
51(1)
6.2 TCD and TCCD
52(1)
6.3 Training Strategies
53(6)
6.4 Learning Through Technological Aid
59(1)
6.5 Learning Through Guidelines and Practice Standards
60(1)
6.6 Competence
61(4)
References
62(3)
Part II Basic and Advanced Parameters
7 Flow Velocity, Pulsatility Index, Autoregulation, and Critical Closing Pressure
65(10)
Marta Fedriga
Marek Czosnyka
7.1 Introduction
65(1)
7.2 Flow Velocity
66(2)
7.3 Pulsatility Index
68(1)
7.4 Critical Closing Pressure
68(2)
7.5 Autoregulation
70(5)
7.5.1 Static Autoregulation
70(1)
7.5.2 Dynamic Autoregulation
70(1)
7.5.3 Continuous Monitoring of Autoregulation
71(1)
References
72(3)
8 Transcranial Doppler and Optic Nerve Ultrasonography for Non-invasive ICP Assessment
75(20)
Danilo Cardim
Chiara Robba
8.1 Introduction
75(1)
8.2 TCD-Derived Pulsatility Index
76(5)
8.3 Methods Based on the Calculation of Non-invasive CPP(nCPP)
81(4)
8.3.1 Aaslid et al. (nICPAaslid)
81(1)
8.3.2 Czosnyka et al. (nICPFVd)
81(3)
8.3.3 Edouard et al. (nICPEdouard)
84(1)
8.3.4 Varsos et al. (nICPccp)
84(1)
8.3.5 Abecasis and Cardim et al. (Spectral nCPP)
85(1)
8.4 Methods Based on Mathematical Models Associating Cerebral Blood Flow Velocity and Arterial Blood Pressure
85(5)
8.4.1 Black-Box Model for ICP Estimation (nICPBB)
85(3)
8.4.2 Cerebrovascular Dynamics Model for Estimation of ICP (nICPHeldt)
88(1)
8.4.3 Models Based on Non-linear Models Between Arterial Blood Pressure and Cerebral Blood Flow Velocity
89(1)
8.4.4 Semi-supervised Machine Learning
89(1)
8.5 Optic Nerve Sheath Diameter Measurement
90(1)
8.6 Take-Home Message for Clinicians
91(1)
8.7 Final Remarks
91(4)
References
91(4)
9 Cerebral Perfusion: Practical Contributions of Transcranial Doppler at Bedside
95(14)
Carla B. Rynkowski
Marcel J. Aries
9.1 Introduction
95(1)
9.2 TCD: Velocity or Flow?
96(1)
9.3 Detection of Conditions That Affect Cerebral Perfusion
97(2)
9.3.1 Noninvasive Estimation of Intracranial Pressure (ICP)
97(1)
9.3.2 Cerebral Vasospasm
97(1)
9.3.3 Hyperperfusion
97(1)
9.3.4 Hypoperfusion
98(1)
9.3.5 Brain Death
99(1)
9.4 Applications of TCD Evaluating Cerebral Perfusion in Common ICU Pathologies
99(6)
9.4.1 Acute Stroke
100(2)
9.4.2 Severe Traumatic Brain Injury
102(1)
9.4.3 Post-out-of-hospital Cardiac Arrest Syndrome
103(1)
9.4.4 Acute Liver Failure
103(2)
9.5 Conclusion
105(4)
References
105(4)
Part III Pathology and Clinical Applications: Emergency Department
10 Emergency Department and Prehospital Brain US as Part of POCUS and US Multiorgan Evaluation
109(20)
Gabriele Via
Tomislav Petrovic
Frank A. Rasulo
10.1 Introduction
109(1)
10.2 BUS in Stroke
110(6)
10.3 BUS Within Whole-Body Ultrasound in Cardiac Arrest and the Post-resuscitation Syndrome
116(4)
10.4 BUS Within Whole-Body Ultrasound in Multiple Trauma
120(9)
References
122(7)
Part IV Pathology and Clinical Applications: General ICU
11 Sepsis, Liver Failure
129(10)
Giovanni Volpicelli
11.1 Introduction
129(1)
11.2 Sepsis
130(3)
11.3 Liver Failure
133(3)
11.4 Conclusion
136(3)
References
137(2)
12 Stroke
139(12)
Victoria A. McCredie
12.1 Introduction
139(1)
12.2 Acute Ischemic Stroke
140(7)
12.2.1 Diagnosis of Stroke Etiology
140(1)
12.2.2 Diagnosis of Large Vessel Occlusion
140(1)
12.2.3 Monitoring of Recanalization
141(2)
12.2.4 Cerebral Autoregulation
143(1)
12.2.5 Hemorrhagic Transformation
144(1)
12.2.6 Midline Shift
145(1)
12.2.7 Multimodal Neuromonitoring Approach
146(1)
12.2.8 Sonothrombolysis
147(1)
12.3 Conclusions
147(4)
References
147(4)
13 Cardiac Arrest
151(10)
Ilaria Alice Crippa
Fabio Silvio Taccone
13.1 Introduction
151(1)
13.2 TCD During Cardiopulmonary Resuscitation
152(2)
13.3 Post-resuscitation Care and Neuro-Prognostication
154(2)
13.4 Conclusions
156(5)
References
157(4)
14 Severe Respiratory Failure: ARDS and ECMO
161(12)
Alberto Goffi
Airton Leonardo de Oliveira Manoel
Chiara Robba
14.1 Introduction
161(1)
14.2 Brain Ultrasonography
162(4)
14.2.1 PEEP and Recruitment Maneuvers
162(1)
14.2.2 Prone Positioning
163(2)
14.2.3 ECMO
165(1)
14.2.4 Identification of Right-to-Left Shunt with TCD
166(1)
14.3 General Ultrasonography
166(1)
14.3.1 Lung Ultrasound
166(1)
14.3.2 Cardiac Ultrasound
166(1)
14.4 Conclusion
167(6)
References
167(6)
Part V Pathology and Clinical Applications: Neuro-ICU
15 Intracerebral Hematomas, Midline Shift, Hydrocephalus
173(10)
Pedro Kurtz
Daniel Paes de Almeida dos Santos
Ivan Rocha Ferreira da Silva
15.1 Introduction
173(2)
15.2 Cerebral Hemodynamics
175(1)
15.2.1 Pulsatility Index, Blood Flow Velocities, and Cerebral Autoregulation
175(1)
15.3 Intracerebral Hematoma
176(1)
15.4 Midline Shift
177(1)
15.5 Other Parameters and Applications
178(1)
15.5.1 Hydrocephalus
178(1)
15.5.2 Subdural Hematomas
178(1)
15.5.3 Cerebral Venous Drainage Assessment
179(1)
15.6 Conclusions
179(1)
15.7 Future Directions
180(3)
References
180(3)
16 Vasospasm After Subarachnoid Hemorrhage
183(10)
Mypinder Sekhon
Oliver Ayling
Peter Gooderham
16.1 Introduction
183(1)
16.2 Pathophysiology of Cerebral Vasospasm and Delayed Cerebral Ischemia
184(1)
16.3 Diagnosis of Cerebral Vasospasm and Delayed Cerebral Ischemia
185(1)
16.4 Transcranial Doppler Principles
185(2)
16.5 Other Diagnostics of Cerebral Vasospasm
187(1)
16.6 Prevention of Vasospasm/Delayed Cerebral Ischemia
188(1)
16.7 Management of Symptomatic Vasospasm
188(1)
16.8 Conclusions
189(4)
References
189(4)
17 Brain US in the Neurological Settings
193(12)
Piergiorgio Lochner
Andrea Naldi
17.1 Introduction
194(1)
17.2 Pseudotumor Cerebri Syndrome
195(1)
17.3 Low-Pressure Syndromes, Cerebrospinal Fluid (CSF) Leaks, and Therapeutical Approaches: Intracranial Hypotension, Patch Test
196(1)
17.4 Posterior Reversible Encephalopathy Syndrome (PRES)
196(1)
17.5 Acute Mountain Sickness (AMS)
196(1)
17.6 Optic Neuritis and Non-arteritic Ischemic Optic Neuropathy
197(1)
17.7 Hydrocephalus
198(1)
17.8 Infections of Central Nervous System
198(1)
17.9 Intracranial Stenosis and Systemic Vasculitis
199(1)
17.10 Parenchymal B Sonography in Neurodegenerative Diseases
200(1)
17.11 Conclusion
201(4)
References
201(4)
18 Brain Death
205(10)
Charu Mahajan
Indu Kapoor
Hemanshu Prabhakar
18.1 Pathophysiology of Brain Death
205(1)
18.2 Diagnosis
206(1)
18.3 TCD Procedure
207(8)
18.3.1 False-Positive and False-Negative Results
209(1)
18.3.2 Other Tests
210(1)
References
210(5)
Part VI Pathology and Clinical Applications: Applications in Neurosurgery
19 Intraoperative Echo in TBI
215(10)
Carlo Giussani
Erik Pietro Sganzerla
Francesco Prada
Andrea Di Cristofori
19.1 Introduction
215(2)
19.2 Utility of ioUS in TBI
217(4)
19.2.1 Intraoperative Use of US
217(1)
19.2.2 Possible Scenarios
218(1)
19.2.3 Explanatory Cases
218(3)
19.3 Future Perspectives
221(4)
References
222(3)
20 Neurosonology in Tropical Medicine
225(18)
David Clark
Peter John Ashton Hutchinson
20.1 Introduction
225(1)
20.2 Neurosonology in Neurological Infections in the Tropics...
226(1)
20.3 Human Immunodeficiency Virus
226(1)
20.4 Tuberculous Meningitis
227(1)
20.4.1 Intracranial Hypertension in TBM
227(1)
20.4.2 Tuberculous Meningitis-Related Vasculopathy
227(1)
20.5 Cryptococcal Meningitis
228(1)
20.5.1 Intracranial Hypertension in CrM
229(1)
20.5.2 Vasculopathy in CrM
229(1)
20.6 Neurocysticercosis
229(1)
20.6.1 Intracranial Hypertension in Neurocysticercosis
230(1)
20.6.2 Vasculopathy in NCC
230(1)
20.7 Cerebral Malaria
230(4)
20.7.1 Raised Intracranial Pressure in Paediatric CM
231(1)
20.7.2 Transcranial Doppler in Paediatric CM
232(2)
20.8 Neurosonology in Non-infectious Diseases in Tropical Regions
234(1)
20.8.1 Sickle Cell Anaemia
234(1)
20.8.2 Hydrocephalus
234(1)
20.8.3 Traumatic Brain Injury
234(1)
20.9 Implementation of Neurosonology in Health Systems in Low- and Middle-Income Countries
235(8)
References
236(7)
Part VII Pathology and Clinical Applications: Specific Considerations
21 Pediatric Population (Pathology and Clinical Applications: Specific Considerations)
243(6)
Llewellyn C. Padayachy
21.1 Introduction
243(1)
21.2 Diagnostic Techniques
244(2)
21.2.1 Transcranial Doppler Sonography (TCD)
244(1)
21.2.2 Transorbital Imaging
244(1)
21.2.3 Transcranial Imaging
245(1)
21.3 Image-Guided Therapeutic Interventions
246(1)
21.4 Intraoperative Navigation
246(3)
References
247(2)
22 Brain Ultrasound in the Critically Ill Pregnant and Puerperium Women
249(10)
Pablo Blanco
Anselmo Abdo-Cuza
22.1 Introduction
249(1)
22.2 Brain Ultrasound
250(1)
22.3 Normal Cerebral Physiology in Pregnancy
250(1)
22.4 Unique Brain Diseases of Pregnancy and Puerperium
251(4)
22.4.1 Preeclampsia and Eclampsia
251(3)
22.4.2 Postpartum Angiopathy
254(1)
22.4.3 Cerebral Venous Sinus Thrombosis
254(1)
22.5 Conclusions
255(4)
References
255(4)
Part VIII Pathology and Clinical Applications: Intraoperative Applications
23 Intraoperative Application of Brain Ultrasound in Non-cardiac Surgery
259(10)
Rita Bertuetti
23.1 Introduction
259(1)
23.2 Techniques and Methods
260(2)
23.2.1 Assessment of CBF: TCD and TCCD
260(1)
23.2.2 Estimation of CPP and ICP
261(1)
23.2.3 Embolism Detection
261(1)
23.3 Clinical Applications
262(7)
23.3.1 Vascular Surgery: Carotid Endarterectomy
264(1)
23.3.2 Pneumoperitoneum and Prone Position
265(1)
23.3.3 Beach Chair Position and Orthopaedic Surgery
266(1)
References
267(2)
24 Cardiac Surgery
269(16)
Massimo Lamperti
Amit Jain
Vinay Byrappa
24.1 Introduction
270(1)
24.2 Basic POCUS-B in Cardiac Surgery
270(1)
24.3 Brain Ultrasound Monitoring in Paediatric Cardiac Surgery
270(3)
24.3.1 Usefulness of Preoperative Brain Ultrasonography in Paediatric Cardiac Surgery
271(1)
24.3.2 Usefulness of Intraoperative Brain Ultrasonography in Paediatric Cardiac Surgery
271(2)
24.4 Brain Ultrasound Monitoring in Adult Cardiac Surgery
273(5)
24.4.1 Preoperative Transcranial Doppler
273(1)
24.4.2 Intraoperative Use of Transcranial Doppler
274(4)
24.5 Multimodal Neurologic Monitoring in Cardiac Surgery
278(1)
24.6 Limitations of Transcranial Doppler in Cardiac Surgery
278(1)
24.7 Conclusions
279(6)
References
279(6)
Part IX Clinical Cases
25 Case 1: Vasospasm Treated with Intra-Arterial Nimodipine
285(4)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
26 Case 2: Vasospasm Treated with Ballooning Angioplasty
289(6)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
27 Case 3: Vasospasm Treated with Ballooning Angioplasty
295(4)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
28 Case 4: aSAH during Pregnancy
299(4)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
29 Case 5: Intracranial Hypertension and Decompressive Craniectomy in Severe aSAH
303(6)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
30 Case 6: Brain Ultrasound for EVD Weaning
309(4)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
31 Case 7: Posterior Cranial Fossa Brain Tumor in a Pediatric Patient
313(4)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
32 Case 8: Cerebral Circulatory Arrest
317(2)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
33 Case 9: Intracranial Hypertension and Hydrocephalus
319(2)
Rita Bertuetti
Nicola Zugni
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
34 Case 10: Intracranial Hypertension and Decompressive Craniectomy
321(4)
Rita Bertuetti
Nicola Zugni
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
35 Case 11: Hydrocephalus with Ventricular Vegetations
325(2)
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
36 Case 12: Intracranial Hypertension after Ischemic Stroke
327
Rita Bertuetti
Maurizio Saini
Davide Savo
Francesca Simonassi
Kartika Chandrapatham
Tarek Senussi
Chiara Robba, after graduating, began her training in Anaesthesia and Intensive Care in Genoa, Italy. She subsequently worked in the Department of Clinical Neurosciences, Addenbrookes Hospital in Cambridge, UK, and completed her PhD on Ultrasound-based non-invasive intracranial pressure under the supervision of Professor Marek Czosnyka. Her main fields of interest are neurosciences and neurocritical care, with a particular focus on brain ultrasound and non-invasive intracranial pressure. She has authored several publications on cerebral haemodynamics in TBI and SAH patients.





Giuseppe Citerio is a Professor of Anaesthesia and Intensive Care at Milano Bicocca University, School of Medicine and Surgery; Director of Anaesthesia and Neurosurgical Intensive Care at San Gerardo Hospital, ASST-Monza; and Director of Anaesthesia and Intensive Care at Desio Hospital, ASST-Monza. After an initial experience at San Raffaele Hospital in Milan, he started Neurointensive and Neuroanesthesia service at San Gerardo Hospital, Monza, in the early 1990s. While at the Neurosurgical Intensive Care Unit, he actively participated in national and international research networks, such as BrainIT and CenterTBI. Dr. Citerio has also been involved in numerous research protocols and drug trials, in many cases acting at the principal investigator. His research activities are focused on TBI, subarachnoid haemorrhage, neuroanesthesia, neurointensive care, and brain death/organ donation. Dr. Citerio has participated in the development of international guidelines on the treatment of patients with subarachnoid haemorrhage and neuromonitoring, and has developed more than 50 courses in Italy and Europe on Neurointensive Care topics. In addition to publishing more than 330 indexed articles, he served as an Associate Editor for the journal Intensive Care Medicine from 2007 to 2012, and is now the journals Editor-in-Chief.