Explain the technique and the different sonographic windows for transcranial duplex Illustrate the normal intracranial vascular anatomy on colour coded transcranial duplex Identify different uses and clinical settings in which transcranial duplex is a useful diagnostic tool

A low-frequency transducer is used to insonate the main cerebral arteries through certain windows and to evaluate changes in cerebral blood flow velocity in different cerebrovascular diseases and brain trauma. It is cheap, repeatable, and permit periodic monitoring of CBFV, which is handy in the intensive care setting. It is helpful to diagnose and analyze vasospasm (VSP) following subarachnoid hemorrhage (SAH) and cerebral hemodynamic changes after stroke including cryptogenic stroke. Moreover, TCD is a valuable diagnostic tool in the management of patients with sickle-cell disease,...

Technique: Patient position: the patient should be lying in supine position, with his head and shoulders on a pillow. Four acoustic windows for TDCS: TEMPORAL WINDOW: The transducer is placed parallel to and just above the zygomatic arch. At this level the butterfly-shape of the midbrain will be located in the middle of the screen. We can identify the M1 and M2 segments of the MCA, A1 segment of the ACA, P1 and P2 segments of the PCA, C1 segment of the carotid siphon, the...

Transcranial color-coded duplex ultrasonography (TCCS) is a reliable neuroimaging tool that allows repeated evaluation of the intracranial circulation which sometimes not achievable by MRI in disoriented patients and helps avoiding the ionizing radiation of the CT angiography.

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