Large Hemispheric Infarction (LHI): Usefulness of Transcranial Doppler (TCD/TCCS)

Large hemispheric infarction (LHI) of the middle cerebral artery is a devastating condition, with a mortality rate that can reach 80% in relation to the treatment modality to which the patient is submitted. Followed by necrosis of the cerebral parenchyma, a large edema is generated, leading to increased intracranial pressure. In this context, the different techniques of neurosonology make it possible to monitor the state of the middle cerebral artery and intracranial circulation in real time, as well as modifications in intracranial pressure based on the determination of the pulsatility index in the opposite hemisphere and the optic nerve sheath diameter. In addition, it allows a quick and reliable diagnosis of the development of a subfascial herniation.