General indications for the use of transcranial Doppler ultrasonography include:Ĭlinical suspicion of cerebral vasculopathyĮvaluation for complications of subarachnoid hemorrhage Neurosonography of the fetal brain, although based on similar principles, will not be discussed this article will focus on neonatal, pediatric, and adult indications for sonographic studies of the brain and cerebral vasculature, especially as it pertains to point-of-care ultrasound.
'TCD' and 'transcranial Doppler' will be used to refer to the combined 2D parenchymal imaging with or without the use of Doppler modalities.Īdvantages of TCD over its 'conventional' predecessor include an ability to identify structural perturbations, including the presence of masses and/or midline shift, and the presence of sonoanatomical landmarks to guide placement of a pulsed wave Doppler gate 18. Some may refer to the imaging modality to be discussed below as transcranial color-coded duplex sonography (TCCS) and the non-imaging based continuous wave Doppler modality as transcranial Doppler (TCD) this article will not make this distinction, as the latter (non-imaging) modality will not be further discussed. An extension of the non-imaging, continuous wave Doppler assessment popular among neurointensivists, the imaging of cerebral structures with grey-scale and superimposed color flow and spectral Doppler analysis is now possible using the same windows, techniques, and diagnostic goals.