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October 1994

Transcranial Doppler Sonography Is at Present of Limited Clinical Value

Arch Neurol. 1994;51(10):1057-1059. doi:10.1001/archneur.1994.00540220105022

Transcranial Doppler sonography (TCD) is already an established diagnostic technique and of proven value in a variety of neurosurgical problems.1 Probably the most important clinical contributions are the monitoring of vasospasm in subarachnoid hemorrhage, identifying patients at risk of delayed ischemic deficits, and for selecting patients for prophylactic antivasospasm therapy2 or carotid occlusion.3 The TCD is also a reliable noninvasive method for monitoring the hemodynamic effects of treatment for arteriovenous malformations.4,5 Intraoperative TCD monitoring of blood flow velocity during carotid endarterectomy is relatively sensitive to hemodynamic events, yet its clinical usefulness has yet to be established.6,7 It has a developing role in the evaluation of intracranial pressure changes in patients with head trauma, since it is atraumatic and repeatable and may help to avoid operative insertion of a transducer in some cases.8,9

The TCD rapidly found a place in neurovascular research soon after the

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