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Point-of-care ultrasound for stroke patients in the emergency room

  • Special Feature: Review Article
  • The role of point-of-care ultrasound (POCUS)
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Abstract

Stroke requires rapid determination of the cause to provide timely and appropriate initial management. Various ultrasonographic techniques have been evaluated as ways to determine the cause of stroke; among them, carotid artery ultrasonography is particularly useful since it provides considerable information within a short time period when used to evaluate a specific site. In the emergency room, carotid artery ultrasonography can be used to diagnose internal carotid artery stenosis, predict an occluded vessel, and infer the cause of ischemic stroke. Additionally, carotid artery ultrasonography can diagnose different conditions including subclavian artery steal syndrome, bow hunter’s stroke, Takayasu’s arteritis, moyamoya disease, and dural arteriovenous fistula. Furthermore, patients with ischemic stroke with a pulse deficit or hypotension must be differentiated from acute type A aortic dissection, which requires emergency surgery; carotid artery ultrasonography can immediately differentiate between the two conditions by identifying the intimal flap of the common carotid artery. The following article provides an overview of carotid artery ultrasonography performed as point-of-care ultrasound in the emergency room in patients with suspected stroke.

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Author information

Authors and Affiliations

  1. Stroke Center, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan

    Hidehiro Takekawa, Daisuke Tsukui & Saro Kobayasi

  2. Department of Neurology, Dokkyo Medical University, Tochigi, Japan

    Hidehiro Takekawa, Daisuke Tsukui, Saro Kobayasi & Keisuke Suzuki

  3. Center of Medical Ultrasonics, Dokkyo Medical University, Tochigi, Japan

    Hidehiro Takekawa

  4. Department of Neurology, Kita-Harima Medical Center, Hyogo, Japan

    Hirotoshi Hamaguchi

Authors
  1. Hidehiro Takekawa
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  2. Daisuke Tsukui
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  3. Saro Kobayasi
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  4. Keisuke Suzuki
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  5. Hirotoshi Hamaguchi
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Correspondence to Hidehiro Takekawa.

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H.T. received lecture fees from Pfizer Japan Inc. and Daiichi Sankyo Co., Ltd. The other authors declare that there are no conflicts of interest.

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No ethical statements are required. This review describes carotid artery ultrasonography as POCUS in stroke patients in the emergency room.

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Takekawa, H., Tsukui, D., Kobayasi, S. et al. Point-of-care ultrasound for stroke patients in the emergency room. J Med Ultrasonics 49, 581–592 (2022). https://doi.org/10.1007/s10396-021-01185-0

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  • DOI: https://doi.org/10.1007/s10396-021-01185-0

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