Role of transcranial Doppler ultrasonography in stroke
This article has been cited by other articles in PMC.
Abstract
Transcranial
Doppler sonongraphy is a non‐invasive, non‐ionising, inexpensive,
portable and safe technique that uses a pulsed Doppler transducer for
assessment of intracerebral blood flow. This article deals with the
principles and technique of transcranial Doppler sonography. It gives a
brief overview of its use in evaluation of intracranial steno‐occlusive
disease, subarachnoid haemorrhage, and extracranial diseases (including
carotid artery disease and subclavian steal syndrome). The role of
transcranial Doppler in detection of microembolic signals and evaluation
of right to left shunts is also dealt with. Finally, its use in acute
stroke is briefly outlined.
Keywords: stroke, transcranial Doppler ultrasoound
Ultrasound
has been used for the evaluation of cerebrovascular disease for over a
decade (20 years old now, your doctors use of it?) and has made considerable progress. Transcranial Doppler
sonography is a non‐invasive, non‐ionising, inexpensive, portable and
safe technique that uses a pulsed Doppler transducer for assessment of
intracerebral blood flow.
With the advent of
thrombolytic treatment for acute ischaemic stroke, the internist would
probably benefit from having a knowledge of transcranial Doppler
ultrasound (TCD), which is a useful tool for the detection of occlusion
of intracranial vasculature. In addition, success of thrombolytic
treatment can also be assessed by TCD.
This
review article aims to provide a basic understanding about the use of
TCD in clinical practice. A brief outline is provided of the principles
and techniques of TCD and its role in acute ischaemic stroke, including
abnormalities affecting both intracranial and extracranial parts of
vessels supplying the brain. We then explore the role of TCD in the
detection of microembolic signals, which help in stratification of risk
of recurrence of stroke or transient ischaemic attack (TIA), and its
role of in the detection and quantification of right‐to‐left shunts. We
also outline the possible role of TCD in subarachnoid haemorrhage and
subclavian steal syndrome. Finally, the role of TCD during carotid
endarterectomy is discussed (box 1).
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