Viviane Flumignan Zetola1, Marcos Christiano Lange2, Valeria Cristina Scavasine2, Rodrigo Bazan3, Gabriel Pereira Braga4, Ana Claudia C B Leite5, Soraia R Cabette Fabio6, Octavio Marques Pontes Neto6, Carla Heloisa Cabral Moro7, Gisele Sampaio8, Edson Bor-Seng Shu8, Marcelo de Lima Oliveira8, Maramelia A de Miranda Alves9, Daniela Laranja Gomes9, Pedro Antonio Pereira de Jesus10, Jamary Oliveira-Filho10, Wagner Mauad Avelar11, Gabriel R de Freitas12, Rafael Borsoi13, Corina Puppo14, Silvia Viviana Cocorullo15, Alejandro Brunser16, Ayrton Massaro17, Natan M Bornstein18, Alexander Razumovsky19, Massimo Del Sette20. 1. Division of Neurology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil, viviane.zetola@gmail.com. 2. Division of Neurology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil. 3. Division of Neurology, School of Medicine of Botucatu, São Paulo State University "Júlio de Mesquita Filho", Botucatu, Brazil. 4. Division of Neurology, Maria Aparecida Pedrossian University Hospital, Federal University of Mato Grosso do Sul, Campo Grande, Brazil. 5. State Institute of Hematology Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil. 6. Division of Neurology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. 7. Division of Neurology, Hospital Municipal Sao Jose, University of Joinville Region, Joinville, Brazil. 8. Division of Neurology, Hospital Israelita Albert Einstein, Federal University of São Paulo, São Paulo, Brazil. 9. Division of Neurology, Hospital São Paulo, Federal University of São Paulo, São Paulo, Brazil. 10. Cardiomyopathy Clinic, Federal University of Bahia, Salvador, Brazil. 11. Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil. 12. Division of Neurology, Instituto D'Or de Pesquisa e Ensino, Federal Fluminense University, Rio de Janeiro, Brazil. 13. Cardiopulmonary Unit, Hospital de Clínicas, Echocardiographic Service, Federal University of Parana, Curitiba, Brazil. 14. Centro de Tratamento Intensivo, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay. 15. Division of Neurology, University of Buenos Aires, Buenos Aires, Argentina. 16. Division of Neurology, Clínica Alemana de Santiago, University of Desarrollo, Santiago, Chile. 17. Division of Neurology, Hospital Sirio Libanês, São Paulo, Brazil. 18. Shaare Zedek Medical Center, Neurology Division, Jerusalem, Israel. 19. SpecialtyCare, Inc, Brentwood, Tennessee, USA. 20. Unità Operativa di Neurologia, Ospedale Galliera, Genova, Italy.
Abstract
BACKGROUND: The role of patent foramen ovale is a field of debate and current publications have increasing controversies about the patients' management in young undetermined stroke. Work up with echocardiography and transcranial Doppler (TCD) can aid the decision with better anatomical and functional characterization of right-to-left shunt (RLS). Medical and interventional strategy may benefit from this information. SUMMARY: a group of experts from the Latin American participants of the Neurosonology Research Group (NSRG) of World Federation of Neurology created a task force to review literature and describe the better methodology of contrast TCD (c-TCD). All signatories of the present consensus statement have published at least one study on TCD as an author or co-author in an indexed journal. Two meetings were held while the consensus statement was being drafted, during which controversial issues were discussed and voted on by the statement signatories. The statement paper was reviewed and approved by the Executive Committee of the NSRG of the World Federation of Neurology. The main objective of this consensus statement is to establish a standardization of the c-TCD technique and its interpretation, in order to improve the informative quality of the method, resulting in expanding the application of TCD in the clinical setting. These recommendations optimize the comparison of different diagnostic methods and encourage the use of c-TCD for RLS screening and complementary diagnosis in multicenter studies.
BACKGROUND: The role of patent foramen ovale is a field of debate and current publications have increasing controversies about the patients' management in young undetermined stroke. Work up with echocardiography and transcranial Doppler (TCD) can aid the decision with better anatomical and functional characterization of right-to-left shunt (RLS). Medical and interventional strategy may benefit from this information. SUMMARY: a group of experts from the Latin American participants of the Neurosonology Research Group (NSRG) of World Federation of Neurology created a task force to review literature and describe the better methodology of contrast TCD (c-TCD). All signatories of the present consensus statement have published at least one study on TCD as an author or co-author in an indexed journal. Two meetings were held while the consensus statement was being drafted, during which controversial issues were discussed and voted on by the statement signatories. The statement paper was reviewed and approved by the Executive Committee of the NSRG of the World Federation of Neurology. The main objective of this consensus statement is to establish a standardization of the c-TCD technique and its interpretation, in order to improve the informative quality of the method, resulting in expanding the application of TCD in the clinical setting. These recommendations optimize the comparison of different diagnostic methods and encourage the use of c-TCD for RLS screening and complementary diagnosis in multicenter studies.