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ISRN Critical Care
Volume 2013 (2013), Article ID 167468, 6 pages
http://dx.doi.org/10.5402/2013/167468
Review Article

Transcranial Sonography and Cerebral Circulatory Arrest in Adults: A Comprehensive Review

1Servei de Medicina Intensiva, Hospital Universitari Son Espases, Carretera Valldemossa 79, 07010 Palma, Spain
2Hans Berger Clinic for Neurology, University Hospital Jena, 07743 Jena, Germany

Received 16 August 2012; Accepted 9 September 2012

Academic Editors: N. Gibney and J. F. Stover

Copyright © 2013 Juan Antonio Llompart-Pou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The diagnosis of brain death remains a clinical challenge for intensive care unit physicians. Worldwide regulations in its diagnosis may differ, and the need of ancillary tests after a clinical examination is not uniform. Transcranial sonography is a noninvasive, bedside, and widely available technique that can be used in the diagnosis of the cerebral circulatory arrest that preceeds brain death. In this paper we review the general concepts, the technical requisites, the patterns of Doppler signal confirming cerebral circulatory arrest, the vessels to insonate, and the options in cases with poor acoustic window. Future research perspectives in the field of transcranial sonography are discussed as well.