At the Columbia Neuro-ICU, the Camino system of fiberoptic monitors is used. These are metallic cylindrical instruments which are inserted such that the tip protrudes into the subarachnoid space. These devices have the advantage of being easy to instal. However, problems with accuracy have limited their use. This is a potential space between the inner surface of the skull and the dura mater.
Cerebral ischemia can result in a stroke.
In this case blood flow is arrested by the presence of a clot in a blood vessel. Patients also can have cerebral ischemia as the result of vasospasm, the contraction of the blood vessels supplying the brain. Blood vessel contraction can result in the obstruction of the lumen of the vessel, leading to cerebral ischemia and a subsequent number of disabilities. In a Neuro-ICU TCD can be used to detect vasospasm before it can give rise to deleterious effects of cerebral ischemia. Transcranial Doppler ultrasonography operates in the following manner.