Transcranial Doppler (TCD/TCCS) Monitoring in the Intensive Care Unit: Usefulness of Two-Dimensional Ultrasound (2D) to Guide Neuromonitoring

Transcranial Doppler (TCD) ultrasound (US) is a simple, non-invasive, relatively inexpensive bedside tool that can provide real-time dynamic information regarding cerebral blood flow velocity (CBFV) in the proximal cerebral blood vessels. TCD is commonly used in neuro-critical care units, acute stroke units, operating rooms, intensive care units, and emergency departments. It can even be useful in an outpatient setting to assess the hemodynamic changes associated with stenosis of major cerebral arteries or to determine the risk of stroke in patients with sickle cell disease. In this chapter, we describe the technique, the indications, and the limitations or pitfalls in using TCD.