title: Neurovascular ultrasound in emergency settings: diagnostic and therapeutic aspects.
abstract: BACKGROUND
  Neurovascular ultrasound is a non-invasive, portable and fast imaging method that, when performed by an experienced neurosonologist, offers reliable and reproducible information on the morphological and hemodynamic status of cervical and intracranial vessels.
  
  
  OBJECTIVE
  To review the available evidence regarding the use of this tool in the approach to acute stroke.
  
  
  METHODS
  Neurovascular ultrasound can be used in one of two ways: diagnostic and therapeutic. Considering the low recanalization rates of internal carotid artery and proximal medial cerebral artery occlusions with intravenous recombinant tissue plasminogen activator (r-tPA), neurovascular ultrasound used shortly in Emergency Department may help to select patients that could benefit from endovascular therapy. Moreover, ultrasound monitorization during intravenous r-tPA treatment allows the analysis of the pattern of arterial recanalization. Cervical ultrasound allows the assessment of the stenosis degree and the composition/surface of an arterial plaque that could, for instance, reveal earlier a candidate for carotid intervention. Finally, the therapeutic potential of ultrasound is also being investigated. Sonothrombolysis and sonolysis, that combine ultrasound technology with r-tPA and use exclusively the ultrasound to lyse the clot, respectively, showed promising results.
  
  
  CONCLUSIONS
  Neurovascular ultrasound has greatly expanded to assume an important role in the study of cerebrovascular disorders.
authors.affiliation: Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: T
authors.initials: T
authors.lastname: Santos
authors.affiliation: Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Veloso
authors.affiliation: Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Barros
mesh_terms: D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D059906:Neuroimaging / Q000379:methods*; D020521:Stroke / Q000000981:diagnostic imaging* / Q000628:therapy*; D018084:Ultrasonography, Interventional