Transcranial Doppler Sonography Is at Present of Limited Clinical Value

Abstract

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