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KEYWORDSPower Doppler ultrasonography; Musculoskeletal pathology; Stroke; Acquired brain injury.Abstract Introduction: The aim of this study was to evaluate the role of bedside ultrasonography (US) in early diagnosis of musculoskeletal complications (MSC) of acquired brain injuries, to describe its incidence and US features in a neurorehabilitation setting. Materials and methods: All 163 patients admitted in tertiary-level neurorehabilitation unit with diagnosis of stroke or severe brain injury (SBI), with symptoms or signs of musculoskeletal pathology, underwent bedside US. Results: MSC were diagnosed in 51.5%. In 86.9% US clarified diagnosis and/or modified therapeutic approach. Shoulder pain was observed in 27.6%. US showed a shoulder subluxation in 73.3% and a frozen shoulder in 8.8% of painful shoulders. In all the cases rotator cuff abnormalities were noted. Wrist-hand syndrome was observed in 29.4%. US showed mild effusion in wrist joints and tendon sheaths and subcutaneous edema without significant vascularity.Neurogenic heterotopic ossification was observed in 1.8%. US demonstrated the "zone phenomenon" or heterogeneously hypoechoic mass with low resistance vessels within the lesions.Contractures and spasticity were observed in 18.4%. US allowed reliable guidance for Botulinum toxin A injection. Relapsing osteoarthritis and acute arthritis were diagnosed in 15.3% and 7.3% respectively. Patients with MSC had lower Functional Independence Measurement (FIM) and Katz index scores in discharge (p < 0.04 and p < 0.0294 respectively) and more length of hospital stay (p Z 0.0024). Discussion: Musculoskeletal pathology frequently complicates the course of acquired brain injuries and it delays functional recovery. Bedside US is a cheap and sensitive diagnostic tool and it can aid clinicians to define diagnosis and to choose therapeutic approach.Sommario Introduzione: Lo scopo di questo studio era quello di valutare il ruolo dell'ecografia (US) eseguita al letto del paziente nella diagnosi precoce delle complicazioni muscolo-scheletriche (MSC) delle cerebrolesioni acquisite, di descriverne incidenza e caratteristiche ecografiche, in una neuroriabilitazione. Materiali e metodi: Tutti i 163 pazienti ricoverati nella unità operativa di terzo livello di neuroriabilitazione con diagnosi di stroke o grave cerebrolesione acquisista (SBI), con sintomi o segni di patologia muscolo-scheletrica, furono sottoposti ad esame US. Risultati: MSC furono diagnosticate nel 51,5% dei pazienti. Nel 86,9% US ha chiarito la diagnosi e/o modificato l'approccio terapeutico. La spalla dolorosa fu rilevata nel 27,6%. US dimostrò una sublussazione di spalla nel 73,3% e una spalla congelata nel 8,8% delle spalle dolorose. In tutti i casi furono osservate alterazioni della cuffia dei rotatori. La sindrome polso-mano fu osservata nel 29,4%. US dimostrava modesto versamento nelle articolazioni e nelle guaine tendinee del polso con edema sottocutaneo senza significativa vascolarizzazione. Le ossificazioni eterotopiche neurogeniche furono osservat...

The present study has been devoted to the analysis of 120 patients presenting with reversible focal cerebral ischemia without conventional signs of cardiopathy and/or relevant atherosclerotic disease. In 77% of the patients vascular risk factors, such as hypertension or hyperlipemia, were present. In 23% of the patients, no abnormal finding was discovered at clinical, hcmatochemical and cardiological examinations. In these patients a further cardiological evaluation was performed with echocardiography. Dynamic electrocardiography was performed in 52 patients. Echocardiography and dynamic electrocardiography revealed the occurrence of 6 cases of mitral valve prolapse (MVP), 2 cases of frequent premature ventricular beats, and 1 proximal atrial arrhythmia. All 6 cases of MVP were detected in the subgroups of patients without vascular risk factors. In our patients younger than 45 years, the relative frequency of MVP attains 21.5%. This study confirms that MVP has to be regarded as a risk factor for focal cerebral ischemia in young patients.