![]() Familiarity with this diagnostic tool is crucial for the modern neurological surgeon.ĭoppler ultrasound detects motion using the difference in frequency between emitted ultrasonic waves and the returning echoes. As the clinical applications of TCD ultrasonography have expanded over time, so has their importance in the management of neurosurgical patients. Finally, assessment of cerebral autoregulation can be performed using TCD ultrasonography, providing data important to the management of patients with severe traumatic brain injury. TCD ultrasonography can identify patients with exhausted cerebrovascular reserve, and after extracranial-intracranial bypass procedures it can be used to assess adequacy of flow through the graft. ![]() Monitoring for microembolic signals enables stratification of stroke risk due to carotid stenosis and can also be used to clarify stroke etiology. TCD ultrasonography is also useful in the evaluation and management of occlusive cerebrovascular disease. In this setting, elevated blood flow velocities serve as a proxy for vasospasm and can herald the onset of ischemia. One of the most common uses of TCD ultrasonography is monitoring for vasospasm following subarachnoid hemorrhage. ![]() In this review, the authors outline the technology underlying TCD ultrasonography and describe its uses in patients with neurosurgical diseases. Transcranial Doppler (TCD) ultrasonography is an inexpensive, noninvasive means of measuring blood flow within the arteries of the brain.
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