Transcranial Doppler Ultrasound: A Review of the Physical Principles and Major Applications in Critical Care

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  • Jawad Naqvi
    University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK
  • Kok Hooi Yap
    Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
  • Gulraiz Ahmad
    Royal Oldham Hospital, Rochdale Road, Manchester OL1 2JH, UK
  • Jonathan Ghosh
    University Hospital South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK

Description

<jats:p>Transcranial Doppler (TCD) is a noninvasive ultrasound (US) study used to measure cerebral blood flow velocity (CBF-V) in the major intracranial arteries. It involves use of low-frequency (≤2 MHz) US waves to insonate the basal cerebral arteries through relatively thin bone windows. TCD allows dynamic monitoring of CBF-V and vessel pulsatility, with a high temporal resolution. It is relatively inexpensive, repeatable, and portable. However, the performance of TCD is highly operator dependent and can be difficult, with approximately 10–20% of patients having inadequate transtemporal acoustic windows. Current applications of TCD include vasospasm in sickle cell disease, subarachnoid haemorrhage (SAH), and intra- and extracranial arterial stenosis and occlusion. TCD is also used in brain stem death, head injury, raised intracranial pressure (ICP), intraoperative monitoring, cerebral microembolism, and autoregulatory testing.</jats:p>

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