Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with intracerebral hemorrhage. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound can produce a variety of therapeutic effects. The use of focused ultrasound for disrupting blood clots, inducing reperfusion of under perfused tissue, and temporarily opening the blood-brain barrier to allow entry of stem cells to populate the area of the stroke are all early stage ideas for treatment. More work is needed to optimize these biomechanisms of focused ultrasound before this research can reach the clinic. Please note that there is another major cause of stroke, listed separately under “Stroke, thromboembolic.”
The primary options for treatment of intracerebral hemorrhage include medications with the possible inclusion of surgery.
For certain patients, focused ultrasound could provide additional treatment options that may have reduced complications and a lower cost.
- Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- Focused ultrasound can be repeated, if necessary.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of of intracerebral hemorrhage.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for intracerebral hemorrhage is not yet approved by regulatory bodies or covered by medical insurance companies.
Gerhardson T, Sukovich JR, Chaudhary N, Chenevert TL, Ives K, Hall TL, Camelo-Piragua S, Xu Z, Pandey AS. Histotripsy Clot Liquefaction in a Porcine Intracerebral Hemorrhage Model. Neurosurgery. 2019 Mar 29. pii: nyz089. doi: 10.1093/neuros/nyz089.
Ilyas A, Chen CJ, Ding D, Romeo A, Buell TJ, Wang TR, Kalani MYS, Park MS. Magnetic resonance-guided, high-intensity focused ultrasound sonolysis: potential applications for stroke. Neurosurg Focus. 2018 Feb;44(2):E12. doi: 10.3171/2017.11.FOCUS17608.
Yang W, Zhou Y. Effect of pulse repetition frequency of high-intensity focused ultrasound on in vitro thrombolysis. Ultrason Sonochem. 2017 Mar;35(Pt A):152-160. doi: 10.1016/j.ultsonch.2016.09.014.
Harnof S, Zibly Z, Hananel A, Monteith S, Grinfeld J, Schiff G, Kulbatski I, Kassell N. Potential of Magnetic Resonance-guided Focused Ultrasound for Intracranial Hemorrhage: An In Vivo Feasibility Study. J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1585-91.
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