![]() ![]() Schematic view of the cerebral circulation, with normal direction of blood flow and transcranial Doppler windows. This review article focuses on the hemodynamic applications of TCD in neurocritically ill patients and discusses the main uses of TCCS. Later technologic advances improved the ease and availability of the method, as well as extended its applications: for example, the introduction of color M-mode to conventional TCD, transcranial color-coded sonography (TCCS), three-dimensional TCCS and contrast-enhanced TCD. For this purpose, using a low-frequency ultrasound probe (e.g., 2 MHz) over specific insonation windows, it is possible to gain access to the arteries that shape the Circle of Willis. Rune Aaslid’s introduction of transcranial Doppler (TCD) in 1982 constitutes an important step for non-invasive bedside study of intracranial artery flow. In these circumstances, other methods, especially non-invasive ones, are of special interest for complementing neuromonitoring. While invasive intracranial pressure (ICP) assessment is considered a standard tool and is widely used, this procedure is not exempt from risks, principally bleeding and infections, as well as the possibility of erroneous readings and the consequent inappropriate treatments. In neurocritically ill patients, multimodality monitoring is of mainstay importance, because clinical examination alone is fairly insensitive to the following disease progression or detecting clinical deterioration. ![]()
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