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Consensus document on neurosonological techniques in headaches
Jaime Rodríguez Vico1, Jéssica Fernández Domínguez2, Francisco José Julián Villaverde3
1Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
Neurologia
|June 23, 2025
Summary
Neurosonology, using ultrasound for nervous system study, offers valuable diagnostic tools for headaches. Guidelines are needed to standardize its use in clinical practice for conditions like arterial dissection and temporal arteritis.
Area of Science:
- Neurology
- Neurosonology
- Medical Imaging
Background:
- Neurosonology, the use of ultrasound for studying the nervous system, has expanding applications.
- Current indications and methods for neurosonology in headache patients are not well-defined.
- A consensus guideline is needed to standardize neurosonology application in clinical practice.
Purpose of the Study:
- To establish a consensus guideline for neurosonology application in patients with headaches.
- To identify primary and secondary headaches where neurosonology has the greatest clinical utility.
- To standardize the methodology for applying neurosonology techniques in headache management.
Main Methods:
- Expert consensus from the Spanish Society of Neurology and Spanish Society of Neurosonology.
- Identification of relevant headache types for neurosonology.
- Qualitative systematic review of existing scientific literature.
Main Results:
- Cervical color duplex ultrasound is a screening tool for suspected arterial dissection and for follow-up.
- Transcranial Doppler evaluates vasospasm via flow velocity and resistance/pulsatility indexes.
- Optic nerve sheath measurement assesses intracranial hypertension; halo sign indicates temporal arteritis.
Conclusions:
- Neurosonology aids in diagnosing arterial dissection, vasospasm, temporal arteritis, and intracranial hypertension.
- Ultrasound techniques can guide procedures like occipital infiltration and lumbar puncture.
- Neurosonology can identify structural changes in migraine pathophysiology, including periaqueductal gray matter and raphe nuclei.
