Clinical applications of point-of-care ultrasound in brain injury: a narrative review

• Published in: Anaesthesia Vol. 77 Suppl 1; no. S1; pp. 69 - 77
• Main Authors: Dinsmore, M, Venkatraghavan, L
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-01-2022
• Subjects: Blood flow; Brain; Brain - diagnostic imaging; Brain Injuries - diagnostic imaging; Brain Injuries - therapy; Brain injury; Brain Ischemia - diagnostic imaging; Brain Ischemia - therapy; Cerebral blood flow; Diagnosis; Doppler effect; Emergency medical care; Emergency medical services; Head injuries; Hematoma; Hemodynamics; Humans; Intracranial pressure; Neuroimaging; Neurology; Point of care testing; Point-of-Care Systems - standards; Radiology; Stroke - diagnostic imaging; Stroke - therapy; Traumatic brain injury; Ultrasonic imaging; Ultrasonography, Doppler, Transcranial - methods; Ultrasonography, Doppler, Transcranial - standards; Ultrasound; Vascular system; brain injury; transcranial Doppler; intracranial pressure; optic nerve sheath diameter; point-of-care ultrasound
• DOI: 10.1111/anae.15604
• EISSN: 1365-2044
• ISSN: 0003-2409

The use of point-of-care ultrasound has increased considerably over the last two decades. It has become a readily available, non-invasive bed-side modality for the rapid diagnosis and management of patients in various settings. Point-of-care ultrasound for assessing the heart, lung, abdomen, airway and vascular systems is now well established. Transcranial Doppler ultrasound for assessing cerebral blood flow has been in use for many years. In recent years, brain ultrasonography has been shown to be a powerful tool in the rapid bed-side assessment of cerebral haemodynamics and structural pathology. Brain ultrasound has been shown to be useful in both the emergency department and neurocritical care setting for the non-invasive assessment of raised intracranial pressure, cerebral autoregulation and diagnosis of intracranial haematoma and other space-occupying lesions. Point-of-care ultrasound is an important alternative technique to routine imaging and invasive monitoring techniques, and results are comparable. Competence is easily attainable without formal radiology training. With technological advancement, applications for the use of brain ultrasound continue to grow. This review discusses the clinical use of point-of-care ultrasound in the diagnosis and management of brain injury.