دانلود کتاب نورسونولوژی در مراقبت های ویژه

Transcranial Doppler, including TCD flow imaging modalities, allows us to access detailed information on the hemodynamics of the cerebral circulation. TCD was first introduced in neuro-critical care to monitor vasospasm in patients after subarachnoid hemorrhage. Since the 1980’s, we have witnessed a remarkable widening of its range of applications. This book is a substantial documentation of this development, describing a true multidisciplinary approach to using TCD (and extracranial Doppler) as a tool to improve neuro-critical care for a broad range of trauma and diseases. The book illustrates convincingly a paradigm change in how TCD is used in investigational studies as well as in clinical practice. Ultrasound Doppler used to be a relatively simple diagnostic handheld tool where the verdict was based on the measured velocities, the pulsatility, and eventual spectral broadening signaling disturbed flow. What led to a shift in paradigm is one of the most important advantages of TCD – the presence of the cranium (really!). In spite of its propensity to dampen the ultrasound and make signal acquisition a bit more difficult, the cranium provides an ideal platform for mounting monitoring TCD probes. And this monitoring can go on and on, and even be aided by robotic technology in an ambulatory setting without somebody there to keep that probe aimed right on its target.