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. 2017 Mar;36(1):3-9.
doi: 10.1016/j.jradnu.2016.11.003. Epub 2017 Feb 16.

Transcranial Doppler Ultrasound Use in Pediatric Traumatic Brain Injury

Karin Reuter-Rice  1
Affiliations

Transcranial Doppler Ultrasound Use in Pediatric Traumatic Brain Injury

Karin Reuter-Rice. J Radiol Nurs. 2017 Mar.

Abstract

Transcranial Doppler ultrasound (TCD) is an inexpensive portable diagnostic tool commonly available within most healthcare systems. A team of trained individuals perform and interpret the test to inform patient care management. The benefit of TCD is well established in adult patients with traumatic brain injury. However, in children with TBI, it is still considered exploratory and its use is not a part of the standard of care. This article describes what TCD is, its use in children, and how TCD measurements apply to children and adolescents in an effort to establish criteria for the use of TCD for children with TBI. The benefit of TCD in pediatric TBI is illustrated by 2 cases of children who participated in a TBI research study. Early indications are that the use of TCD in pediatric cases of TBI may produce unexpected real-time data about the cerebral vasculature and circulation characteristics in children with TBI. Transcranial Doppler ultrasound has the potential for playing an informative diagnostic role in future pediatric TBI management. Ultimately the goal to promote best outcomes after a TBI requires insights into the multi-dynamic nature of the injury and TCD has the ability to support these efforts.

Keywords: cerebral flow velocity; children; head injury.

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Figures

Figure 1
Figure 1
Example of a mean flow velocity of the left middle cerebral artery (L-MCA) at a depth of 50mm with a flow of 101cm/sec and a pulsitility index (PI) of 0.52.
Figure 2
Figure 2
A change in the quality of the waveform when the left middle cerebral artery (L-MCA) is interrogated from a depth of 50mm to 55mm.
Figure 3
Figure 3
Example of mean flow velocities of the left middle cerebral artery (L-MCA), the basilar artery (BA) and the right middle cerebral artery (R-MCA). The color Doppler flow tracings demonstrate a L-MCA at a velocity of 87.0cm/sec at a depth of 50mm and a pulsatility index (PI) 1.50, BA velocity of 51.2cm/sec at a depth of 70mm with a PI of 1.29 and a R-MCA velocity of 92.4cm/sec at a depth of 50mm with a PI 1.13.
Figure 4
Figure 4
First 24 hour TCD results in a 4 year old girl admitted to hospital for a severe TBI.
Figure 5
Figure 5
First 24 hour TCD results in a 15-year-old boy admitted to hospital for a severe TBI.
See this image and copyright information in PMC

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