![]() ![]() test for vasomotor instability in migraine and concussion patients.monitor response to tPA with acute stroke and inform prognosis.test for “downstream exhaustion” of cerebrovascular autoregulation.screen for vertebrobasilar insufficiency.can also identify microemboli associated with cardiac or vascular hardware, atrial fibrillation, and asymptomatic carotid artery disease that can inform management.validated approach to identifying any right-to-left shunting, including a patent foramen ovale (PFO).can also identify aberrant direction of flow, which can be seen as a pathological response to major cerebrovascular disease.can identify narrowing of any of major vessels at the base of the brain and requires no contrast injection.TCD has a number of inpatient and outpatient indications. TCD can also be affixed with a head frame and used as a monitoring tool to screen for right-to-left shunting of saline microbubble contrast, spontaneous asymptomatic microemboli, atypical reactions to a vasodilatory stimulus, and flow changes based on head and body movement. TCD is a useful tool for screening for major intracranial stenosis (> 50% luminal narrowing) and intracranial occlusions, validated against conventional and non-invasive angiography. The simplicity of the data acquired belies the many clinically useful findings that can be inferred from patterns of flow velocity and directional change. TCD provides information on flow velocity and direction of flow in a segment of the vessel investigated. ![]() These include the middle cerebral arteries (MCAs), anterior cerebral arteries (ACAs), terminal internal carotid arteries (tICAs), posterior cerebral arteries (PCAs), ophthalmic arteries (OAs), intracranial vertebral arteries (VAs) and the basilar artery (BA). Transcranial Doppler, or TCD, is an ultrasound-based, safe, non-invasive means of dynamically surveying flow velocity and pathologic changes in the large arteries at the base of the brain. ![]()
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