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Review
. 2016 Apr-Jun;26(2):28-41.
doi: 10.4103/2211-4122.183746.

Transcranial Doppler Ultrasound: Physical Principles and Principal Applications in Neurocritical Care Unit

Antonello D'Andrea  1 , Marianna Conte  1 , Raffaella Scarafile  1 , Lucia Riegler  1 , Rosangela Cocchia  1 , Enrica Pezzullo  1 , Massimo Cavallaro  1 , Andreina Carbone  1 , Francesco Natale  1 , Maria Giovanna Russo  1 , Giovanni Gregorio  2 , Raffaele Calabrò  1
Affiliations
Review

Transcranial Doppler Ultrasound: Physical Principles and Principal Applications in Neurocritical Care Unit

Antonello D'Andrea et al. J Cardiovasc Echogr. 2016 Apr-Jun.

Abstract

Transcranial Doppler (TCD) ultrasonography is a noninvasive ultrasound study, which has been extensively applied on both outpatient and inpatient settings. It involves the use of a low-frequency (≤2 MHz) transducer, placed on the scalp, to insonate the basal cerebral arteries through relatively thin bone windows and to measure the cerebral blood flow velocity and its alteration in many different conditions. In neurointensive care setting, TCD is useful for both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoid hemorrhage, traumatic brain injury, acute ischemic stroke, and brain stem death. It also allows to investigate the cerebrovascular autoregulation in setting of carotid disease and syncope. In this review, we will describe physical principles underlying TCD, flow indices most frequently used in clinical practice and critical care applications in Neurocritical Unit care.

Keywords: Brain stem death; Neurocritical Unit Care; cryptogenic stroke; mean cerebral brain flow; paradoxical embolism; patent foramen ovale; subarachnoid hemorrhage; transcranial Doppler ultrasonography; traumatic brain injury; vasospasm.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Left panel: Transmission of ultrasound beam through skull using Pulsed Doppler sectorial probe with a 2.0–3.5 MHz emission frequency. Probe is positioned on temporal window. Right panel = Circle of Willis
Figure 2
Figure 2
Mesencephalic view. It is clearly distinguishable the middle cerebral artery
Figure 3
Figure 3
Transcranial Doppler spectral Doppler study of intracranial middle cerebral artery. MCA = Middle cerebral artery
See this image and copyright information in PMC

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