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Limitations and Pitfalls

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Echography and Doppler of the Brain

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Abstract

Cranial ultrasound and pulse Doppler imaging of the cerebral vasculature is an important noninvasive portable bedside modality for rapid and continuous assessment of patients with acute neurological injury. Optimal use of this dynamic modality depends on an in-depth knowledge of ultrasound physics, proper technique in acquisition of images, cerebrovascular anatomy, and familiarity with sonographic manifestations of cerebrovascular changes seen in brain injuries of different etiologies. Consistent reproducibility of echography and Doppler images is key to its clinical value as a diagnostic and monitoring tool, especially in today’s neuroimaging realm of easy access to vascular neuroimaging through computed tomography or digital subtraction angiography. Interrater reproducibility of ultrasound and its correlation with other diagnostic modalities can be enhanced by strict adherence to imaging protocols and familiarity with artifacts and pitfalls for high-quality image acquisition. In instances where the diagnostic physician analyzing the images is different than the sonographer performing the echography, analysis of static images post hoc creates additional need for high standards of knowledge in technical, anatomical, and clinical considerations. This chapter discusses the limitations of the cranial ultrasound, non-imaging transcranial pulse Doppler, and color duplex imaging. Pitfalls in the technical use and clinical applications of these imaging modalities are also discussed.

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Author information

Authors and Affiliations

  1. Neurology, Wake Forest School of Medicine, Winston Salem, NC, USA

    Aarti Sarwal

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  1. Aarti Sarwal
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Correspondence to Aarti Sarwal .

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Editors and Affiliations

  1. Anesthesia and Intensive Care, Policlinico San Martino, IRCCS for Oncology and Neuroscience, Genoa, Italy

    Chiara Robba

  2. Anesthesia Neurosurgical Intensive Care, ASST Monza School of Medicine, University of Milano, Bicocca, Milano, Italy

    Giuseppe Citerio

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Sarwal, A. (2021). Limitations and Pitfalls. In: Robba, C., Citerio, G. (eds) Echography and Doppler of the Brain. Springer, Cham. https://doi.org/10.1007/978-3-030-48202-2_5

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  • DOI: https://doi.org/10.1007/978-3-030-48202-2_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-48201-5

  • Online ISBN: 978-3-030-48202-2

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