Transcranial Color-coded Sonography (TCCS): A Helpful Tool In Clinical Neurology

Since its introduction by Aaslid in 1982, transcranial Doppler sonography has become firmly established both as a routine instrument for assessing the intracranial hemodynamic situation in a hospital situation and experimentally in the field of functional Doppler sonography. An extended procedure consisting of a combination of B mode and PW Doppler sonography and offering the possibility of visualizing the insonated tissue has been available since the start of the '90s as transcranial colorcoded sonography (TCCS). The aim of this paper is to provide an overview of the current state of applications for TCCS from the standpoint of the hospital physician. After describing the examination procedure and values for normal populations, the paper focuses on the emergency diagnosis of patients with acute ischemic cerebral infarction within a short time after the event. The rapid differential diagnosis of stroke (within 3 hours after the onset of sym-ptoms) together with clinical data and the CT finding permits a rational decision regarding reca-nalizing therapy with t-PA. The importance of routine bedside follow-up examinations with TCCS in various indications is discussed together with their yield, patient friendliness and cost effectiveness. Finally, the paper takes a look at coming developments in the field of multidimen-sional sonography of intracranial structures.