Transcranial doppler

This was vaguely touched upon in several questions, but never directly assessed:

Question 13 from the first paper of 2006 (regarding brain death)

Question 2 from the first paper of 2008 (regarding the use of ultrasound in general)

Question 8 from the first paper of 2008 (regarding the diagnosis of vasospasm)

Question 5 from the first paper of 2013 (regarding the diagnosis of brain death)

Question 2 from the second paper of 2013 (again about the vasospasm)

2MHz low frequency probe on temporal bone to measure flow in MCA.

  • normal flow: mean = 55cm/sec
  • mild stenosis: > 120cm/sec
  • moderate stenosis: > 160cm/sec
  • severe stenosis: > 200cm/sec

Useful for the following:

  • emboli
  • stenosis
  • vasospasm post SAH
  • assessment of cerebral blood flow

Non-invasive and easily repeatable.


  • Vasospasm or hyperaemia can both cause increased flow velocity
  • sensitivity 80% compared to angiography
  • Operator dependent
  • Other than ICA and MCA, unable image the other vessels
  • Dependent on a good view
  • Multiple confounding factors; haematocrit, blood pressure, etc.
  • Not validated for use in diagnosis of brain death by ANZICS