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Neurosonology in ICU: Transcranial Color-Coded Duplex Sonography (TCCS) Protocol

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Neurosonology in Critical Care

Abstract

In 1982, Aaslid was the pioneer in evaluating intracerebral arteries with TCD through an intact skull. This allowed a blind measure of cerebral blood flow velocities of the basal cerebral arteries and an indirect evaluation of the perfusion of the brain.

Technical improvements by using transcranial color-coded duplex sonography (TCCS) with low-frequency probes (2 MHz) have made possible the direct visualization of brain parenchyma and cerebral vessels. Direct visualization of the arteries allows for the correction of the insonation angle and a more accurate measurement of cerebral flow velocities. The orientation of blood flow in the vessels and the visual estimation of the blood flow velocities are possible due to color-coded Doppler.

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Author information

Authors and Affiliations

  1. Intensive Care Medicine, Hospital Nacional Prof. Dr. A. Posadas, University of Buenos Aires (UBA), Neurointensive Care Section - ESICM, Neurointensive Care Section - AMCI, Neurointensive Care Committee - FEPIMCTI, Member of ESNCH, Buenos Aires, Argentina

    Camilo N. Rodríguez

  2. Intensive Care Medicine and Neurology, FMH Chez Centre Qorpus. Clinique des Grangettes, Geneva, Switzerland

    Deborah Pugin

Authors
  1. Camilo N. Rodríguez
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  2. Deborah Pugin
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Correspondence to Camilo N. Rodríguez .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Buenos Aires, Buenos Aires, Argentina

    Camilo N. Rodríguez

  2. Stroke Unit & Neurosonology Lab, University of Padua School of Medicine, Padova, Italy

    Claudio Baracchini

  3. Department of Critical Care and Anesthesiology, Fundación Valle del Lili, Cali, Colombia

    Jorge H. Mejia-Mantilla

  4. Department of Clinical Neurosciences Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK

    Marek Czosnyka

  5. Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jose I Suarez

  6. President of Hungarian Neurological Society, Department of Neurology, Clinical Center Debrecen University, Debrecen, Hungary

    László Csiba

  7. Intensive Care Unit, Clinics Hospital, Universidad de la Republica School of Medicine, Montevideo, Uruguay

    Corina Puppo

  8. Center for Neurological Vascular Diagnostics, Munich, Germany

    Eva Bartels

Algorithm

Algorithm

figure a

ABCD Airway-breathing-circulation-disability, GCS Glasgow coma scale, FVs Peak systolic velocity, FVm Mean velocity, MCA Middle cerebral artery, ACA Anterior Cerebral Artery, PCA Posterior Cerebral Artery, BA Basilar Artery, VA Vertebral Artery, OA Ophthalmic artery, ONSD optic nerve sheath diameter, CRA Central retinal artery, ICPn Non-invasive intracranial pressure, CBFV Cerebral blood flow velocity, LV Lateral ventricle, PICA Postero-inferior cerebellar artery, TI Thermal index, MI Mechanical index, Mx Mean flow index, Sx systolic flow index, PRx Pressure reactivity index.

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Rodríguez, C.N., Pugin, D. (2022). Neurosonology in ICU: Transcranial Color-Coded Duplex Sonography (TCCS) Protocol. In: Rodríguez, C.N., et al. Neurosonology in Critical Care . Springer, Cham. https://doi.org/10.1007/978-3-030-81419-9_14

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  • DOI: https://doi.org/10.1007/978-3-030-81419-9_14

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