Carotid Ultrasound
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Ultrasound can be used to examine the extracranial arteries that supply blood to the brain. Pathology in these arteries can lead to stroke. A carotid ultrasound exam should image and measure blood flow in the carotid and vertebral arteries bilaterally and evaluate any lesions found. Ultrasound is a noninvasive way to detect pathology in the extracranial arteries that may cause stroke.
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This document provides an overview of performing a normal carotid artery Doppler study. It discusses the anatomy of the carotid arteries and examines protocol, including using high-frequency transducers, color Doppler, and analyzing Doppler spectral waveforms. The appearance of normal carotid artery walls and blood flow characteristics are described. Tips are provided for differentiating the external and internal carotid arteries. The document references sources for further information on vascular ultrasonography techniques and carotid artery anatomy.
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2. Normal vessels have characteristic flow patterns depending on their anatomy and the organ they supply. Widening of the spectral line and filling of the spectral window indicates high flow or small vessels.
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1) Carotid Doppler ultrasound is used to evaluate the carotid arteries for stenosis or occlusion. It involves using grayscale, color Doppler, and spectral Doppler to examine the anatomy and flow of the carotid arteries.
2) A normal carotid Doppler ultrasound will show triphasic waveforms within the carotid arteries with velocities under 125 cm/sec. The intima-media thickness should be less than 0.8-0.9mm.
3) Carotid artery disease is most commonly caused by atherosclerosis which can be evaluated using Doppler ultrasound parameters like peak systolic velocity, end diastolic velocity, and ICA/CCA velocity ratios to grade the severity of stenosis.
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Carotid artery Doppler uses ultrasound to examine the carotid arteries in the neck. It can detect plaques, stenosis, dissections, and other abnormalities. A normal study shows the carotid bifurcation into the internal and external carotid arteries, with the internal carotid having low resistance flow and the external carotid having reduced diastolic flow. Doppler waveform analysis examines flow patterns to identify abnormalities. The test is used to evaluate risks of stroke and transient ischemic attacks.
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1. Doppler spectroscopy provides a time-velocity waveform representing blood flow velocities during the cardiac cycle, showing how velocity and the number of reflecting red blood cells varies over time.
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3. Pseudoaneurysms are caused by a complete rupture of the artery wall. Doppler can detect the communicating channel showing a "to-and-fro" waveform as blood enters and leaves the pooling cavity.
4.
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1) Carotid Doppler ultrasound is used to evaluate the carotid arteries for stenosis or occlusion. It involves using grayscale, color Doppler, and spectral Doppler to examine the anatomy and flow of the carotid arteries.
2) A normal carotid Doppler ultrasound will show triphasic waveforms within the carotid arteries with velocities under 125 cm/sec. The intima-media thickness should be less than 0.8-0.9mm.
3) Carotid artery disease is most commonly caused by atherosclerosis which can be evaluated using Doppler ultrasound parameters like peak systolic velocity, end diastolic velocity, and ICA/CCA velocity ratios to grade the severity of stenosis.
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- Characteristics of normal flow patterns seen in major vessels and how they relate to vessel anatomy and organ function.
- Abnormal flow patterns seen in pseudoaneurysms and arteriovenous fistulas which involve damage to vessel walls. Specific waveform patterns are described that indicate these conditions.
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- Technique for performing carotid Doppler ultrasound exams, including patient positioning, transducer use, and Doppler settings
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- Causes of carotid artery disease and common sites of extracranial arterial disease
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Carotid Doppler involves B-mode, color Doppler, and spectral Doppler analyses of the carotid arteries. Spectral Doppler provides information on flow patterns, velocities, and pulsatility which can identify stenosis or occlusion. Plaque characterization evaluates composition and risk of embolism. Carotid Doppler is useful for evaluating TIAs, bruits, known disease, and pre-operative screening.
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The study investigated the incidence and risk factors of venous obstruction before and after implantation of transvenous pacing leads in 131 patients using digital subtraction angiography (DSA). DSA was performed before implantation and at 44 months follow-up in 79 patients. Prior to implantation, venous obstruction was found in 18 patients (13.7%), mainly in the left innominate vein. After implantation, venous obstruction occurred in 26 of 79 patients (32.9%) at follow-up DSA. There were no significant differences in risk factors between patients with or without obstruction. The incidence of obstruction after implantation was lower than previous reports, possibly due to pre-existing obstruction being identified prior to implantation.
jurnal DUS.pdf
1) Doppler ultrasonography is a valuable noninvasive technique for evaluating peripheral arterial disease in the lower extremities, allowing direct visualization of plaques and analysis of Doppler waveforms.
2) Proper scanning requires knowledge of the arterial anatomy of the lower extremities and techniques such as using color and pulsed-wave Doppler.
3) Key arteries include the femoral, popliteal, tibial and pedal arteries. Scanning is done in transverse and longitudinal planes with the transducer positioned appropriately based on the patient position and artery being imaged.
Ccsvi and ms ameds centrum
1. The document discusses Chronic Cerebrospinal Venous Insufficiency (CCSVI), a condition linked to multiple sclerosis (MS) where veins draining the brain and spinal cord are narrowed or blocked.
2. It provides details on diagnosing and treating CCSVI using procedures like Doppler ultrasound, MRI, venography, and venous angioplasty to widen blocked veins.
3. While the relationship between CCSVI and MS is still being studied, the document reports that over 600 MS patients treated for CCSVI experienced reduced fatigue, improved quality of life, psychological state, and physical condition based on evaluation scales.
1 enfermedad cv ateroesclerótica figura 1 (1)
This document summarizes recent advances in imaging technologies for detecting and assessing atherosclerotic cardiovascular disease. It discusses how MRI, CT, and molecular imaging techniques can now detect atherosclerosis earlier in its development by imaging plaque composition in arterial walls, in addition to imaging advanced stenosis and its effects. These new imaging approaches may help stratify disease risk, monitor treatment effects, and improve understanding of atherosclerosis biology.
The role of Echocardiography In coronary artery disease and Acute Myocardial...
This document discusses the role of echocardiography in diagnosing coronary artery disease and acute myocardial infarction. It begins by explaining that echocardiography provides important information about cardiac function and hemodynamics, and is useful when electrocardiograms or cardiac enzyme levels are non-diagnostic for patients experiencing chest pain. It then describes how echocardiography can be used to evaluate left ventricular function, wall motion abnormalities, and rule out other potential causes of chest pain. The document focuses on how echocardiography is used to diagnose acute coronary syndrome, locate the site of myocardial infarction, and estimate infarct size. It also discusses techniques like strain imaging and speckle tracking echocardiography that can provide additional quantitative analysis
Thermal Imaging for the Diagnosis of Early Vascular Dysfunctions: A Case Report
Diseases of blood vessels (referred in this article as vascular dysfunction) cause more morbidity and mortality, than combined impact of any other major non-communicable disease including cancer. We strongly feel that the development of a therapy system based on the management of disease of the vessel than management of the risk factors will yield better results and provide greater opportunity for individualized therapy. Detection of early vascular changes before clinical manifestations of endothelial dysfunction, hardening of the arteries, increased intima-media thickness, is of great importance for early identification of individuals with increased risk of accelerated atherosclerosis.
Correlation Between ECG Changes and 2D Speckle Tracking Echocardiography with...
This study aimed to correlate 2D speckle tracking echocardiography with coronary angiography results in 100 patients with non-ST elevation myocardial infarction (NSTEMI). Echocardiography, including speckle tracking, was performed to assess wall motion abnormalities and territorial longitudinal strain. Coronary angiography identified the culprit artery. Speckle tracking showed high sensitivity and specificity in identifying the culprit artery compared to angiography results, with sensitivity of 93.3% for left anterior descending artery, 82.7% for left circumflex, and 84% for right coronary artery. This suggests speckle tracking may help localize coronary stenosis and identify which NSTEMI patients could benefit from revascularization.
Echocardiography Analysis
1) Echocardiography allows me to apply my knowledge of anatomy and physiology to help diagnose heart conditions in a non-invasive manner. 2) I am drawn to its technology aspects and how ultrasound imaging has advanced our understanding of cardiovascular diseases. 3) It is a growing field with job opportunities, and I want to provide valuable diagnostic information to cardiologists and improve patient care.
1512.full
The study investigated the relationship between dilated Virchow-Robin spaces (VRS) seen on MRI and cerebral microvascular disease in elderly patients with dementia. 75 patients with Alzheimer's disease, ischemic vascular dementia, or frontotemporal dementia underwent MRI and were compared to 35 healthy volunteers. VRS scores were significantly higher in patients with vascular dementia compared to those with Alzheimer's disease, frontotemporal dementia, or healthy volunteers. VRS scores accounted for 29% of the variance in a regression model, more than periventricular hyperintensities, suggesting dilated VRS are a sensitive indicator of cerebral microvascular disease.
Abstract world congress
This document summarizes two studies on percutaneous left ventricular assist devices (LVADs) and coronary artery fistulas.
The first study investigated the ability of a percutaneous LVAD to deliver blood to the systemic circulation during cardiac arrest in pigs. The LVAD maintained blood flow and preferentially perfused vital organs like the brain. Intensified fluid loading further improved LVAD performance.
The second study evaluated the microvascular effects of ultrasound contrast (Definity) in hamsters with conditions like ischemia-reperfusion, diabetes, and sepsis. Inflammatory responses were higher in diabetes with ischemia and sepsis groups, independent of contrast use. Contrast did not alter hemodynamics or reology.
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This document summarizes myelin-associated glycoprotein (MAG) neuropathy. It presents as a chronic, slowly progressive large-fiber sensory-motor polyneuropathy, usually affecting the lower extremities initially. Diagnosis involves detecting anti-MAG antibodies and demonstrating demyelination on electrophysiology. While the condition progresses slowly over decades, it can ultimately cause significant muscle weakness, wasting, and ataxia. Current treatments focus on B cell depleting therapies like rituximab, while future therapies may involve antigen-specific immunotherapy.
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Acute Exacerbation of Trigeminal Neuralgia.pptx
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Role of Clopidogrel in Minor Stroke and Transient Ischaemic Attack.pptx
This document discusses the role of clopidogrel in treating transient ischemic attack (TIA) and minor stroke. It defines TIA and stroke, and explains that clopidogrel works by inhibiting platelet activation and aggregation. It reviews several clinical trials that evaluated the efficacy of clopidogrel combined with aspirin in secondary stroke prevention. The recommendations from health organizations like AHA/ASA and ESO are that clopidogrel can be used for secondary stroke prevention in ischemic stroke. For high-risk TIA or minor stroke patients who are not at high bleeding risk, the recommendation is dual antiplatelet therapy with clopidogrel and aspirin for 21 days, followed by single antiplatelet therapy thereafter.
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Transient epileptic amnesia (TEA) is a form of focal epilepsy characterized by recurrent episodes of retrograde or anterograde amnesia. During episodes, patients exhibit repetitive questioning and confusion but otherwise intact neurological function. Diagnosis requires witnessed amnesic episodes, intact cognition otherwise during episodes, and evidence of epilepsy from EEG, seizures, or response to anti-seizure medication. TEA can be differentiated from conditions like transient global amnesia and is frequently underdiagnosed in older adults.
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An epidural blood patch involves injecting the patient's own blood into the epidural space to treat a post-dural puncture headache that has not responded to conservative treatments like bed rest. It has an 85% success rate initially and up to 90% with repeated patches. The procedure involves identifying the epidural space and slowly injecting 5-25mL of blood drawn from the patient over 30-60 seconds. Complications can include worsening headaches from additional dural rents, back pain, or infection at the injection site.
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Spontaneous intracranial hypotension is a medical condition caused by loss of cerebrospinal fluid from the spinal canal, resulting in headaches and neurological symptoms. It most commonly presents with orthostatic headaches that are less apparent over time. Brain MRI and spine MRI are used to diagnose and locate CSF leaks. Treatment involves conservative measures, percutaneous patching of leaks, or surgical closure. Spontaneous intracranial hypotension can lead to complications like subdural hematomas if not properly diagnosed and treated.
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This document discusses tauopathies, which are neurodegenerative diseases characterized by abnormal tau aggregates in neurons and glial cells. Tau is a microtubule-associated protein that promotes cytoskeleton structure and axonal transport in the nervous system. In tauopathies, tau becomes pathological and forms inclusions like paired helical filaments. Tauopathies show heterogeneity in clinical presentations depending on the type and location of tau aggregates. Classification is based on the tau isoforms involved, with 4-repeat tauopathies including progressive supranuclear palsy and corticobasal degeneration. Understanding tau aggregation mechanisms and their role in toxicity is important for developing targeted therapies for these diseases.
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Primary progressive aphasia (PPA) is a neurodegenerative syndrome characterized by a gradual deterioration of language abilities over time due to left-hemisphere brain atrophy. It is classified into three main variants - logopenic, nonfluent agrammatic, and semantic - based on distinct language profiles and brain regions affected. Diagnosing PPA and differentiating between variants can be challenging due to overlapping language impairments, clinical variability, and disease progression over time. Management involves a multidisciplinary approach, though treatment options are limited as there is no cure currently.
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Carotid Ultrasound
- 1. CAROTID ULTRASOUND Ade Wijaya, MD November 2017 Landwehr, P., Schulte, O., & Voshage, G. (2001). Ultrasound examination of carotid and vertebral arteries. European radiology, 11(9), 1521-1534.
- 2. Introduction Stroke is one of the leading causes of dead & disability Extracranial arteries supply the brain Pathology on these arteries lead to stroke Can be examined using ultrasound Can be managed by either surgery or endovascular technique.
- 3. Findings should include: 1. Longitudinal image, Doppler spectrum, and velocitymeasurements in the common carotid artery on either side 2. Longitudinal image and transverse image of the carotid bifurcation on either side 3. Longitudinal image, Doppler spectrum, and velocity measurements of the internal and external carotid arteries and vertebral arteries 4. If pathological findings are noted: longitudinal image with Doppler spectrum of the respective lesion
- 6. Other Findings Kinking and coiling of the carotid artery Subclavian steal syndrome Stenoses and occlusions of the vertebral artery AV fistulae Glomus tumor
- 7. Summary Ultrasound is a cheap, noninvasive method to detect extracranial arteries pathology DSA is still the gold standard