Contrast agents to recover nondiagnostic bedside brain ultrasound in neurocritical care

Contrast-enhanced transcranial ultrasound may salvage nondiagnostic bedside neuro point-of-care ultrasound exams by improving Doppler signal and vessel visualization, but needs structured training and validated velocity cutoffs.

• Contrast agents can recover diagnostic information when acoustic windows are poor, improving Doppler signal and vessel visualization.
• Potential bedside applications include vasospasm monitoring, intracranial pressure assessment, steno-occlusive disease, and cerebral circulatory arrest.
• Current limitations include operator dependence, nonstandard protocols, and the need for structured training and validated velocity cutoffs.

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