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Role of transcranial Doppler ultrasonography in stroke

The Ayr Hospital, Dalmellington Road, Ayr, Ayrshire, UK

Correspondence to:
Dr Sandip Kumar Ghosh, The Ayr Hospital, Dalmellington Road, Ayr, Ayrshire, KA6 6DX, UK; sandy.ghosh{at}aaaht.scot.nhs.uk

ABSTRACT
Transcranial Doppler sonongraphy is a non-invasive, non-ionising, inexpensive, portable and safe technique that uses a pulsed Doppler transducer for assessment of intracerebral blood flow. This article deals with the principles and technique of transcranial Doppler sonography. It gives a brief overview of its use in evaluation of intracranial steno-occlusive disease, subarachnoid haemorrhage, and extracranial diseases (including carotid artery disease and subclavian steal syndrome). The role of transcranial Doppler in detection of microembolic signals and evaluation of right to left shunts is also dealt with. Finally, its use in acute stroke is briefly outlined.

Abbreviations: ACA, anterior cerebral artery; HITS, high intensity transient signals; ICA, internal carotid artery; MCA, middle cerebral artery; MES, microembolic signals; PCA, posterior cerebral artery; PFO, patent foramen ovale; PI, pulsatility index; SAH, subarachnoid haemorrhage; TCD, transcranial Doppler ultrasound; TIA, transient ischaemic attack; TIBI, Thrombolysis In Brain Ischaemia; TOE, transoesophageal echocardiography

Keywords: stroke; transcranial Doppler ultrasoound