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EL ULTRASONIDO CON DISPOSITIVOS PORTATILES ES UTIL PARA EL DIAGNOSTICO DEL ICTUS AGUDO

EL ULTRASONIDO CON DISPOSITIVOS PORTATILES ES UTIL PARA EL DIAGNOSTICO DEL ICTUS AGUDO

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La ecografía Doppler transcraneal y el dúplex carotídeo pueden realizarse mediante dispositivos portátiles, lo que permite su utilización junto a la cama del paciente en el Servicio de Urgencias y en la sala de neurointervencionismo.
martinez9_91112.jpg Autor:
Patricia Martínez Sánchez
Columnista Experta de SIIC

Institución:
Hospital Universitario La Paz


Artículos publicados por Patricia Martínez Sánchez
Recepción del artículo
24 de Noviembre, 2011
Aprobación
2 de Agosto, 2012
Primera edición
21 de Septiembre, 2012
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La ecografía Doppler transcraneal (EDTC) y el dúplex carotídeo (DC) pueden realizarse mediante dispositivos portátiles, lo que permite su utilización junto a la cama del paciente en el Servicio de Urgencias y en la sala de neurointervencionismo. Ambas técnicas permiten el diagnóstico del estado del árbol vascular cerebral y facilitan un diagnóstico rápido y una decisión terapéutica adecuada. Existe una creciente utilización del dúplex transcraneal (DuTC), que nos permite, además, la valoración del parénquima cerebral, lo que es especialmente útil en la monitorización de la evolución de las hemorragias cerebrales, el efecto masa intracraneal y la hidrocefalia. Finalmente, la EDTC tiene un efecto terapéutico, ya que potencia la recanalización con activador tisular del plasminógeno (tPA). La EDTC, el DuTC y el DC son herramientas diagnósticas excelentes que deberían utilizarse en la evaluación inmediata de todos los pacientes con ictus isquémico o hemorrágico agudo.

Palabras clave
ultrasonido transcraneal, ultrasonido carotídeo, ecocontrastes, infarto cerebral, hemorragia cerebral


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Abstract
Transcranial Doppler (TCD) and carotid duplex (CD) can be used as portable tests, thus allowing for bedside use in the Emergency Service and Neurointerventional Room. Both tests broaden the abilities of the stroke neurologist to rapidly evaluate the vascular tree, facilitating a rapid diagnosis and appropriate therapeutic decisions. There is a growing use of transcranial duplex (TCDu), which also allows assessment of the brain parenchyma, which is especially useful in monitoring the evolution of brain hemorrhage, intracranial mass effect and hydrocephalus. Finally, the TCD has a therapeutic effect because it enhances arterial recanalization after tPA administration. The TCD, TCDu and CD are excellent diagnostic tools that should be used in all patients with ischemic or hemorrhagic stroke.

Key words
transcranial ultrasound, carotid ultrasound, microbubble contrast agents, brain infarction, cerebral hemorrhage


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cuidados Intensivos, Diagnóstico por Imágenes
Relacionadas: Emergentología, Geriatría, Medicina Interna, Neurocirugía, Neurología, Salud Pública



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Patricia Martínez Sánchez, Hospital Universitario La Paz Centro de Ictus y Servicio de Neurología, Madrid, España
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