Transcranial Doppler Ultrasound Interpretation: A Non-Invasive Imaging Technique for Cerebral Blood Flow Monitoring

Transcranial Doppler (TCD) ultrasound interpretation is a non-invasive imaging technique used to measure cerebral blood flow velocity (CBF-V) in the major intracranial arteries. First described in 1982, TCD has become a valuable tool in various medical settings, including intensive care units and neurosurgical departments.

One of the key advantages of TCD is its ability to provide dynamic monitoring of CBF-V and vessel pulsatility over extended time periods with high temporal resolution. This allows for continuous bedside monitoring of cerebral blood flow velocity, which is particularly useful in critically ill patients. Additionally, TCD is relatively inexpensive, repeatable, and portable, making it an attractive option for hospitals and healthcare facilities.

However, the performance of TCD is highly operator dependent, which can limit its utility. Inadequate transtemporal acoustic windows are a common problem, with approximately 10-20% of patients experiencing difficulties during TCD examinations. Furthermore, acquiring a three-dimensional understanding of cerebrovascular anatomy necessary for competency requires a significant amount of training and expertise.

Despite these limitations, TCD is used in various clinical settings to diagnose and monitor several conditions, including vasospasm in sickle cell disease, subarachnoid hemorrhage (SAH), intra- and extracranial arterial stenosis and occlusion. It is also used for brain stem death, head injury, raised intracranial pressure (ICP), intraoperative monitoring, cerebral microembolism, and autoregulatory testing.

In conclusion, TCD ultrasound interpretation is a valuable non-invasive imaging technique that offers several advantages over other imaging methods. While it requires significant training and expertise to acquire competency, its ability to provide dynamic monitoring of CBF-V and vessel pulsatility makes it an attractive option for healthcare professionals.

Transcranial doppler ultrasound interpretation