A cerebral embolism occurs when a blood clot forms in another part of the body, often the heart or arteries in the upper chest and neck, and moves through the bloodstream until it hits an artery too narrow to let it pass.
TCD ultrasound is currently the gold-standard test to detect, localize, and quantify cerebral embolism.
Clear exam results with emboli automatically flagged for review
Extended monitoring with autonomous signal reacquisition upon patient movement
Safe tracking of patient progress in real time for the full exam duration
Live exam streaming with notification of key events
There is a significant risk of stroke during cardiac procedures due to embolic activity or lack of blood flow.
Electroencephalography (EEG) is often used to monitor the status of neuronal activity in the brain during surgery. However, a recent case study of patients undergoing carotid endarterectomy revealed that TCD correctly indicated injury that resulted in transient functional deficits, while EEG did not.1
Continuous real-time data provides critical insight into embolic activity and blood flow, enabling immediate treatment decisions while the patient is still in the operating room.
Learn more about how the real-time blood flow data provided by the NovaSignal Platform allows clinicians to immediately respond to perioperative concernsdownload THE CASE
Costin M, Rampersad A, Solomon RA, Connolly SS, Heyer EJ. Cerebral Injury Predicted by Transcranial Doppler Ultrasonography But Not Electroencephalography During Carotid Endarterectomy. J Neurosurg Anesthesiol. 2002 Oct;14(4):287-92.
Moore WS, Barnett HJM, Beebe HG, Bernstein EF, Brener BJ, Brott T, Caplan LR, Day A, GoldstoneJ, Hobson II RW, Kempczinski RF, Matchar DB, Mayberg MR, Nicolaides AN, NorrisJW, Ricotta JJ, Robertson JT, Rutherford RB, Thomas D, Toole JF, Trout III HH, Wiebers DO. Guidelines for Carotid Endarterectomy. Circulation. 1995;91:566–579.
Careful evaluation and workup for an embolic source is mandatory to guide appropriate evidence-based treatment and reduce the risk of stroke recurrence.
There are three main mechanisms that can cause an ischemic stroke; thrombosis, hypoperfusion, or emboli. Ischemic strokes of cardioembolic source are generally the most severe ischemic stroke subtype.
The spatial and temporal resolution of TCD ultrasound make it the gold-standard test to detect, localize, and quantify cerebral embolism. TCD is also useful in detection of the embolic source (heart vs. brain) and any underlying vascular pathology. TCD is recommended for emboli monitoring in patients with embolic stroke of undetermined source (ESUS) with no obvious source of plaque and only minor stenosis, but present atrial fibrillation.
Learn more about how the real-time blood flow data provided by the NovaSignal Platform allows clinicians to immediately respond to embolic activitydownload THE CASE
Alexandrov, A. V., Sloan, M. A., Tegeler, C. H., Newell, D. N., Lumsden, A., Garami, Z., Levy, C. R., Wong, L. K., Douville, C., Kaps, M., Tsivgoulis, G., & American Society of Neuroimaging Practice Guidelines Committee (2012). Practice standards for transcranial Doppler (TCD) ultrasound. Part II. Clinical indications and expected outcomes. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 22(3), 215–224