[Clinical relevance of detection of microembolism signals with transcranial Doppler ultrasound diagnosis].
Detection of microembolic signals (MES) has been described in several patients groups. A potential clinical relevance of this technique has been established (1) during the first hours following carotid endarterectomy and (2) for patients with asymptomatic ICA stenosis or various autoimmune disorders. Intraoperative monitoring in patients undergoing cardiac or carotid surgery can be used to improve the surgical technique but provides no prognostic information for individual patients. Microembolic signals in patients with prosthetic heart valves cannot be used as markers for stroke risk; their potential significance as markers for neuropsychological deficits remains unclear. Recent reports suggest that MES can be used as surrogate markers for assessing the efficacy of antiplatelet agents. The fact that automated MES detection is not feasible greatly reduces the technique's applicability. On the whole, MES detection--with the exception of the patient groups listed above--provides pathophysiological rather than clinically relevant information.
Georgiadis
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D
Klinik für Neurologie, Universität Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg. dimitri_georgiadis@med.uni-heidelberg.de
Schwab
S
S
Baumgartner
R W
RW
D005240:Feasibility Studies; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017585:Ultrasonography, Doppler, Transcranial