E. B. Ringelshtein
University Hospital Münster, Department of Neurology – Münster, Germany

Microembolic signals (MES) detected by transcranial ultrasound have first been described in the 80ies by Merrill Spencer and have rapidly gained great importance for the exploration of the pathophysiology underlying various stroke etiologies. Finally, MES have been proven as a reliable biomarker concerning the prognosis of symptomatic and asymptomatic internal carotid artery (ICA) stenoses. Typical clinical indications for microembolus detection (MD), a time-consuming, investigator-dependent US technique, are monitoring of cardiac and carotid surgery, arterial interventions, detection of occult sources of embolism, defining the culprit in competing sources of embolism, development of less emboligenic surgical techniques and refined devices.