Related Experiment Video
Updated: Jul 13, 2026
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
[Cerebral hemodynamics in patients with traumatic brain injury evaluated by transcranial Doppler and transcranial
J Homar1, J M Abadal, J A Llompart-Pou
1Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, Palma de Mallorca.
Insights
Transcranial color coded sonography (TCCS) identifies more cerebral vessels and provides higher hemodynamic measurements in traumatic brain injury (TBI) patients compared to transcranial Doppler (TCD). TCCS offers a high-quality hemodynamic assessment for TBI patients in the ICU.
Area of Science:
- Neuroimaging
- Vascular Neurology
- Critical Care Medicine
Context:
- Traumatic brain injury (TBI) necessitates accurate hemodynamic assessment for effective management.
- Conventional transcranial Doppler (TCD) has limitations in visualizing cerebral vasculature and quantifying blood flow parameters.
- Neurocritical Intensive Care Units (ICUs) require advanced diagnostic tools for TBI patients.
Purpose:
- To compare the diagnostic yield and hemodynamic parameter accuracy of TCD versus transcranial color coded sonography (TCCS) in TBI patients.
- To evaluate the number of identified Circle of Willis vessels and hemodynamic values (mean velocity, pulsatility index) between TCD and TCCS.
- To assess the feasibility and quality of TCCS for hemodynamic evaluation in TBI patients within an ICU setting.
Summary:
- TCCS demonstrated significantly higher rates of insonation for the internal carotid artery (95% vs 29%), middle cerebral artery (95% vs 93%), anterior cerebral artery (91% vs 67%), and posterior cerebral artery (92% vs 35%) compared to TCD.
- Mean blood flow velocities were significantly higher with TCCS than TCD in the MCA (79 vs 59 cm/sec), ACA (61 vs 42 cm/sec), and PCA (43 vs 33 cm/sec), all with p<0.0001.
- TCCS provided superior visualization of cerebral vessels and yielded higher hemodynamic measurements in TBI patients.
Impact:
- TCCS offers a high-quality, comprehensive hemodynamic study for TBI patients in the ICU, potentially improving diagnostic accuracy.
- The findings suggest TCCS may be a more effective tool than TCD for assessing cerebral hemodynamics in TBI.
- Further research is warranted to determine the clinical impact of TCCS on TBI patient outcomes.
Objective:
To compare the number of vessels identified and mean velocity and pulsatility index values obtained by transcranial doppler (TCD) and transcranial color coded sonography (TCCS) in patients with traumatic brain injury (TBI).
Methods:
Thirty patients suffering from TBI admitted in our neurocritical Intensive Care Unit (ICU) were studied. We performed consecutive studies by TCD and TCCS. The number of Circle of Willis vessels insonated and the hemodynamic parameters were compared.
Results:
Mean age was 50 years. Twenty patients were male. By using TCCS, internal carotid artery was insonated in 95%, middle cerebral artery (MCA) in 95%, anterior cerebral artery (ACA) in 91% and posterior cerebral artery (PCA) in 92% of the studies. Using conventional TCD they were insonated in 29%, 93% 67% and 35% of the studies respectively. Mean velocity values measured by CCS and TCD in MCA were 79 cm/sec vs 59 cm/sec respectively (p< 0.0001), in ACA were 61 cm/sec vs 42 cm/sec (p< 0.0001) and in PCA were 43 cm/sec vs 33 cm/sec (p< 0.0001).
Conclusion:
TCCS allows a high quality hemodynamic study of TBI patients admitted to the ICU. Further studies must define its impact on outcome of TBI patients.
