Use of Transcranial Doppler Ultrasonography

The Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology has released a guideline on transcranial Doppler ultrasonography (TCD) and transcranial color-coded sonography as a diagnostic aid in patients with cerebrovascular disease. “Assessment: Transcranial Doppler Ultrasonography” appears in the May 2004 issue of Neurology and is available online at http://www.aan.com/professionals/practice/guideline/index.cfm#Child.

According to the guideline, TCD provides valuable information in two situations: (1) screening children two to 16 years of age with sickle cell disease for risk of stroke, and (2) detecting and monitoring of vasospasms after subarachnoid hemorrhage.

In other situations, TCD was found to provide important information, but the value of the test, compared with other tests, has not been determined. These include detection of cerebral circulatory arrest and brain death, and monitoring of coronary artery bypass graft operations.

In some situations, TCD does provide important information, but other tests are preferable. These include detection of right-to-left cardiac shunts, and evaluation of extracranial internal carotid artery stenosis.