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Large Hemispheric Infarction (LHI): Usefulness of Transcranial Doppler (TCD/TCCS)

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Neurosonology in Critical Care

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Abstract

Large hemispheric infarction (LHI) of the middle cerebral artery is a devastating condition, with a mortality rate that can reach 80% in relation to the treatment modality to which the patient is submitted. Followed by necrosis of the cerebral parenchyma, a large edema is generated, leading to increased intracranial pressure. In this context, the different techniques of neurosonology make it possible to monitor the state of the middle cerebral artery and intracranial circulation in real time, as well as modifications in intracranial pressure based on the determination of the pulsatility index in the opposite hemisphere and the optic nerve sheath diameter. In addition, it allows a quick and reliable diagnosis of the development of a subfascial herniation.

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Author information

Authors and Affiliations

  1. Department of Neurology, Stroke Unit, Eugenio Espejo Hospital, Quito, Ecuador

    Claudio E. Scherle Matamoros

Authors
  1. Claudio E. Scherle Matamoros
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Corresponding author

Correspondence to Claudio E. Scherle Matamoros .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Buenos Aires, Buenos Aires, Argentina

    Camilo N. Rodríguez

  2. Stroke Unit & Neurosonology Lab, University of Padua School of Medicine, Padova, Italy

    Claudio Baracchini

  3. Department of Critical Care and Anesthesiology, Fundación Valle del Lili, Cali, Colombia

    Jorge H. Mejia-Mantilla

  4. Department of Clinical Neurosciences Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK

    Marek Czosnyka

  5. Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jose I Suarez

  6. President of Hungarian Neurological Society, Department of Neurology, Clinical Center Debrecen University, Debrecen, Hungary

    László Csiba

  7. Intensive Care Unit, Clinics Hospital, Universidad de la Republica School of Medicine, Montevideo, Uruguay

    Corina Puppo

  8. Center for Neurological Vascular Diagnostics, Munich, Germany

    Eva Bartels

Algorithm

Algorithm

figure a

ABCD Airway-breathing-circulation-disability, GCS Glasgow coma scale, NIHSS National Institute of Healt Stroke Scale, ICA Internal Carotid Artery, MCA Middle Cerebral Artery, ONSD Optic Nerve Sheath Diameter, CT Computed Tomography.

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Scherle Matamoros, C.E. (2022). Large Hemispheric Infarction (LHI): Usefulness of Transcranial Doppler (TCD/TCCS). In: Rodríguez, C.N., et al. Neurosonology in Critical Care . Springer, Cham. https://doi.org/10.1007/978-3-030-81419-9_45

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  • DOI: https://doi.org/10.1007/978-3-030-81419-9_45

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-81418-2

  • Online ISBN: 978-3-030-81419-9

  • eBook Packages: MedicineMedicine (R0)

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