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

Abstract

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.

Keywords: brain injury; intracranial pressure; optic nerve sheath diameter; point-of-care ultrasound; transcranial Doppler.