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Transcranial doppler is utilized to investigate the intracranial vasculature for various purposes. It offers a non-invasive, radiation-free way to monitor for sequelae from subarachnoid hemorrhage or to help determine stroke risk in sickle cell patients. This activity reviews a few examples of transcranial Doppler exam indications, basic techniques, and the importance these findings have in clinical care by the interprofessional team. Objectives: Identify common indications for transcranial Doppler examination. Describe transcranial Doppler findings associated with vasospasm in subarachnoid hemorrhage patients. Summarize the basic technique of transcranial Doppler examination. Outline the importance of TCD exam in the screening of pediatric sickle cell disease patients. Access free multiple choice questions on this topic.
Transcranial Doppler (TCD) is a non-invasive ultrasound technique, not utilizing ionizing radiation. This technique takes advantage of acoustic windows present in the skull to interrogate the intracranial vascular structures. Various vascular measurements can be determined, including cerebral blood flow velocity, which can affect many different pathologies. Common indications for TCD include screening for vasospasm in patients with subarachnoid hemorrhage, screening for signs of angiopathy in pediatric sickle cell disease patients, and evaluation for a right-to-left shunt in the setting of stroke and suspected paradoxical embolism (patent foramen ovale and other pathologies).[1] This article will focus on these common indications.
Transcranial Doppler is a technique that can be used in various ways for various indications. An important part of this is the technologist performing the exam. They are critical to deriving the benefit from this exam because if it is not performed properly and to the highest standard, patient outcomes will not be optimal. Clear and open communication between the technologist and the physician is also paramount for clear, precise, and effective results. To further improve patient outcomes, the technologist must understand critical results so the physician can be notified promptly and minimize delay in care.