Stroke-point-of-care ultrasound: a new holistic approach to bedside evaluation in stroke patients using ultrasound

Early identification of stroke aetiology, hemodynamic monitoring and detection of complications represent key challenges for vascular neurologists. Stroke-point-of-care ultrasound (Stroke-POCUS) has emerged as a structured framework for integrating multimodal bedside ultrasound into stroke management.

Stroke-POCUS involves the comprehensive bedside use of various ultrasound modalities, including cervical and transcranial ultrasound, orbital ultrasound, echocardiography, venous system ultrasound, lung ultrasound, abdominal ultrasound and interventional ultrasound. These modalities are applied in an integrated manner to assess stroke patients in the acute setting, aiming to support diagnosis, etiological investigation, detection of complications and monitoring of treatment response, as an adjunct, not a substitution for computed tomography, magnetic resonance imaging, or standard comprehensive ultrasound examination.

The integration of multiple ultrasound modalities within Stroke-POCUS enables clinicians to obtain rapid, noninvasive answers to well-defined clinical questions at the patient's bedside and in real time. This capability is particularly critical for patients requiring expedited diagnostics prior to urgent treatment initiation, for clinically unstable patients in whom intrahospital transport carries an increased risk of complications, as well as for assessing potential underlying causes, identifying secondary complications and monitoring treatment efficacy.

Stroke-POCUS represents a comprehensive bedside imaging strategy that enhances the evaluation and management of stroke patients. By integrating multiple ultrasound techniques, it provides a more holistic view of stroke pathophysiology, complications and treatment monitoring, potentially improving clinical decision-making and individualised patient care.