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TCD ultrasound provides rapid, noninvasive, non-expensive, repeatable, and real-time measures of cerebrovascular hemodynamics. TCD used to measure linear cerebral blood flow velocity (CBFV) in the basal arteries of the brain to assess relative changes in blood flow, diagnose focal vascular stenosis, or detect embolic signals within these arteries. TCD has established utility in the clinical diagnosis of a number of CVD such as acute ischemic stroke, vasospasm after SAH and TBI (mild, moderate and severe), intracranial hypertension, sickle cell disease, presence of patent foramen ovale, as well as other conditions confirmation of total cessation of brain blood flow as an ancillary test for clinical diagnosis of brain death. 

The value of TCD in clinical practice is well established, especially to measure and grade cerebral hemodynamics changes evoked by different neurological and neurosurgical diseases. Based on Guidelines and Recommendations from American Heart Association/American Stroke Association, American Academy of Neurology, American Academy of Neurological Surgery, American Society of Neuroimaging and Neurocritical Care professional societies and many years of clinical practice TCD is a tool employed by the Neurosurgeon, Neurointensivist, Neurologist and Cardiologist in the management of patients with CVD

Specific TCD Clinical applications for Neurosurgery, NeuroCritical Care and Critical Care
Specific TCD clinical applications for Neurology (inpatient or
outpatient settings)
  • Cerebral vasospasm diagnosis after TBI, SAH and tumor resection

  • Cerebral vasospasm daily monitoring after TBI, SAH and tumor resection

  • Cerebral vasospasm treatment (medical or endovascular) effect evaluation

  • Patent Foramen Ovale screening for the risk assessment

  • Evaluation of carotid endarterectomy/carotid stenting effect and potential hyperperfusion after the intervention

  • Brain embolization monitoring in patients with acute cerebral ischemia

  • Pre- and post-treatment AVM evaluation

  • Fat Emboli monitoring

  • Dialysis and dialysis disequilibrium

  • Severe acute hepatic encephalopathy

  • Coagulopathy and ICP monitoring

  • Cardiac arrest and the post-cardiac arrest syndrome

  • Meningitis

  • Follow-up after organ transplant

  • Evaluation of Intracranial Hypertension

  • Brain Death evaluation: ancillary test to confirm the total cerebral circulatory arrest

  • Evaluation effect of extracranial lesion on cerebral perfusion in patients with asymptomatic or symptomatic carotid arteries lesions

  • Brain embolization monitoring in patients with asymptomatic and symptomatic carotid lesions

  • Evaluation of cerebrovascular reactivity in patients with asymptomatic or symptomatic carotid arteries lesions

  • Evaluation of cerebral hemodynamics and cerebrovascular reactivity in patients after concussion 

  • Evaluation of intracranial arterial circulation (stenosis, Moya-Moya, cerebral arteritis)

  • Evaluation of positional vertigo, syncope, dizziness, orthostatic hypotension

  • Evaluation of patients with Sickle Cell disease

  • Evaluation of patients with an Acute/Subacute stroke/TIA

  • Real-time monitoring of recanalization after t-PA or mechanical thrombectomy

  • Evaluation of brain embolization

  • Evaluation of Patent Foramen Ovale in patients with cryptogenic stroke

  • Evaluation of Patent Foramen Ovale in patients with migraine

  • Functional TCD 

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