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Die Notfalltherapie und Intensivtherapie bei Schlaganfall pp 15–24Cite as

Neurosonologische Diagnostik beim Schlaganfall

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Summary

Neurosonological procedures are very suitable for diagnostic clarification in all phases of cerebrovascular disease. Doppler sonography which is based on the effect described by Christian Doppler 1843 measures bloodflow velocity. For the Duplex-technique two-dimensional sectional images are generated. Flow information can be determined by insertion of a doppler information. By the application of contrast media in combination with specific ultrasonic modes, like the perfusion harmonic imaging (PHI) and the stimulated acoustic emission (SAE), it is possible to represent blood flow in the cerebral microcirculation.

In the early phase of ischemic stroke neurosonological procedures can help to clarify the substantial question about presence of an intracranial vessel occlusion. Transcranial doppler (TCD) and transcranial color coded duplex (TCCD) both revealed a high sensitivity for proofing of intracranial occlusions. Ethiological classification of stroke, which is important in the subsequent phase of stroke, is a domain of neurosonological techniques, because sensitivity and specifity of these techniques to detect extra- or intracraniallesions are very high. Also for detection of cardial right-to-Ieft shunt neurosonological techniques exists. A special application for transcranial B-mode is the measurement of the midline-shift under the circumstance of large hemispheric stroke. The fields of application of the neurosonological techniques in the post acute phase are particularly the examination of the risk and the effectiveness of secondary preventive measures, like CEA or stenting.

Zusammenfassung

Neurosonologische Verfahren eignen sich hervorragend zur diagnostischen Abklärung in allen Phasen zerebrovaskulärer Erkrankungen. Die auf dem von Christian Doppler 1843 beschriebenen Effekt basierende Doppler-Sonographie verwendet die korpuskulären Blutbestandteilen als Reflektor zur Messung der Blutflussgeschwindigkeit. Bei der Duplexsonographie werden zweidimensionale Schnittbilder mit der B-Bild-Technik generiert. Durch Einblendung eines Doppler-Strahles können Geschwindigkeitsinformationen aus bestimmten Bildteilen ermittelt werden. Durch den Einsatz von Ultraschall-Kontrastmittel (UKM) gelingt es in Kombination mit UKM-spezifischen Ultraschallverfahren, wie dem „Perfusion Harmonic Imaging“ (PHI) und der„stimulierten akustischen Emission“ (SAE) Kontrastmittel als Indikator für fließendes Blut in der zerebralen Mikrozirkulation darzustellen.

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Authors and Affiliations

  1. Neurologische Klinik, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany

    P. A. Ringleb

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  1. P. A. Ringleb
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  2. G. Seidel
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© 2003 Springer-Verlag Berlin Heidelberg

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Ringleb, P.A., Seidel, G. (2003). Neurosonologische Diagnostik beim Schlaganfall. In: Die Notfalltherapie und Intensivtherapie bei Schlaganfall. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57384-2_3

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  • DOI: https://doi.org/10.1007/978-3-642-57384-2_3

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-1384-6

  • Online ISBN: 978-3-642-57384-2

  • eBook Packages: Springer Book Archive

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