Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1996
Review[Circulating cerebral microembolisms. Detection with transcranial Doppler ultrasound].
Ischaemic stroke is predominantly caused by cerebral emboli which may originate from cardiac sources or atherosclerotic lesions of the cerebral arteries. The diagnosis is primarily based on clinical symptoms and may be confirmed by typical patterns in cranial computed tomography. Echocardiography, ultrasonography of the supraaortic vessels, and angiography are additional diagnostic tools and helpful in clarifying the pathogenesis. ⋯ The high number of patients after valve replacement showing up to 30 embolic signals per minute without suffering from neurologic symptoms raises the question whether continuous, predominantly gaseous microembolisation may cause cumulative brain damage. At present, the nature of emboli (gaseous vs. solid) cannot be easily identified by TCD in clinical settings. Future technical improvement of ultrasonic devices may solve this problem, since detection of solid rather than gaseous emboli seems more likely to be clinically relevant.