The Neuro Ultrasound Laboratory at Wake Forest Baptist is an integral part of the clinical evaluation, monitoring and follow-up of patients with stroke or cerebrovascular disease.
When a patient is at risk for stroke, or other types of cerebrovascular disease, ultrasound is a safe and noninvasive tool to find evidence of vascular disease. Ultrasound has become a routine part of the initial evaluation of people with transient ischemic attacks (TIAs) and strokes. If the ultrasound reveals a blockage or something unusual, then our doctors can order further testing to confirm what they are visualizing on the ultrasound.
Ultrasound testing also offers an effective method for doctors to follow patients who are potentially at risk. For example, if you have minor carotid stenosis, your doctor can follow you with ultrasound testing and recommend medications, additional testing, or surgery when and if the stenosis becomes a potential risk for a stroke.
In the laboratory, we perform the following ultrasound tests:
- Carotid ultrasound - This test looks for blockages in the carotid artery, the main supply of blood to the brain. We use it to screen patients who may be at risk for carotid stenosis or to determine if a patient has a blockage in the carotid artery. After a carotid endartectomy is performed, your neurosurgeon may continue to use carotid ultrasound to ensure that the endartectomy worked and the blockage is gone.
- Transcranial Doppler - This test can detect blockages or vasospasm (vessel spasm) in the brain arteries inside the skull following subarachnoid hemorrhage—which can cause a stroke. This can happen between 5 or 14 days after the hemorrhage ruptures. By using Transcranial Doppler, our physicians can better identify and treat patients who have vasospasm and prevent their strokes.
We also use ultrasound to:
- Determine risk of cerebral embolization - If you have a blood clot sitting in your heart, or plaque in a brain artery, there is risk for a piece to break off and move to your head. By using ultrasound, we can identify plaque in the carotid arteries, and detect passage to the brain or very tiny bits of blood clot or plaque material. This helps understand the risk for, or cause of, stroke, allowing treatment to prevent a new stroke.
- Evaluate or assess cerebrovascular reserve - Strokes can occur because there is not an adequate supply of blood to the brain. We use ultrasound to evaluate patients’ cerebrovascular reserve—typically during a stress test of the brain arteries —so we can make sure there is normal capacity to increase flow of blood to the brain when under stress. If you cannot increase blood flow during a stress test, your brain is at risk for stroke.
About the Neuro Ultrasound Laboratory
We are one of the only facilities of our type in North Carolina, and for the past 30 years have trained more than 3,000 doctors and technologists on how to use ultrasound for the effective diagnosis of stroke and cerebrovascular disease.
We are accredited by the ICAVL (The Intersocietal Commission for the Accreditation of Vascular Laboratories), the gold stamp of approval in neurovascular testing.