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Anaesthesiology
Brain Ultrasound
Built from Practical Ultrasound in Anesthesia
What’s inside
3 sections · 64 slides
Overview
- What brain ultrasound offers
- Origins of brain ultrasound
- TCD versus TCCD
- Probe choice and depth
Acoustic windows and technique
The four acoustic windows, how to find each vessel, and how to read flow velocity.
- Four acoustic windows
- The Doppler equation
- Temporal window: placement
- Mesencephalic plane
- Reading the mesencephalic plane
- Ventricular and thalamic planes
- Third ventricle view
- Lateral ventricles view
- Difficult temporal windows
- Circle of Willis with color Doppler
- Circle of Willis with color Doppler
- Contralateral and deep vessel views
- Middle cerebral artery flow velocities
- Posterior cerebral artery flow velocity
- Anterior cerebral artery flow velocity
- Transorbital window: placement and safety
- Transorbital vascular views
- Optic nerve sheath diameter measurement
- Optic nerve sheath diameter (ONSD)
- Occipital window: vertebral arteries
- Right vertebral artery (occipital window)
- Left vertebral artery
- Occipital window: basilar artery
- Basilar artery insonation
- Submandibular window: placement
- Submandibular window: findings
- External carotid artery
- Internal carotid artery
- Why flow velocity matters
- The injury cascade
- How TCCD samples flow
- What changes flow velocity
- Systolic, diastolic and mean velocity
- Pulsatility and resistivity indices
- Lindegaard ratio for vasospasm
Clinical applications
Hemorrhage, midline shift, hydrocephalus, vasospasm, autoregulation, raised pressure and brain death.
- Where TCCD helps
- Detecting intracerebral hematoma
- Measuring midline shift
- Detecting hydrocephalus
- Subarachnoid hemorrhage and vasospasm
- Vasospasm time course
- Vasospasm on transcranial Doppler
- Grading vasospasm with velocity
- Cerebral autoregulation
- Detecting intracranial hypertension
- Raised intracranial pressure waveform
- Confirming brain death
- Cerebral circulatory arrest in brain death
- 20%
- Brain ultrasound in practice
- References
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- Practical Ultrasound in Anesthesia for Critical Care and Pain Management