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Updated: Feb 16, 2026
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
The characteristics of transcranial color-coded duplex sonography in children with cerebral arteriovenous
Vlasta Duranovic1, Katarina Vulin2, Ivana Dakovic2
1Department of Neuropediatrics, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia. vlasta.duranovic@kdb.hr.
Insights
Transcranial color-coded duplex sonography (TCCS) effectively detects cerebral arteriovenous malformations (AVMs) in children experiencing headaches. This non-invasive method aids in diagnosis and monitoring of AVMs.
Area of Science:
- Pediatric Neurology
- Vascular Imaging
- Neurosonology
Background:
- Cerebral arteriovenous malformations (AVMs) are rare vascular anomalies often presenting in childhood with intracranial hemorrhage.
- Headache is a common symptom in pediatric patients with cerebral AVMs, necessitating accurate diagnostic tools.
Purpose of the Study:
- To evaluate the utility of transcranial color-coded duplex sonography (TCCS) in detecting cerebral AVMs in children presenting with headaches.
- To assess TCCS as a diagnostic and follow-up tool for pediatric cerebral AVMs.
Main Methods:
- The study involved five pediatric patients diagnosed with cerebral AVMs and presenting with headaches.
- Initial diagnosis and detection of AVMs were performed using TCCS.
- Confirmatory diagnostic procedures included magnetic resonance imaging (MRI) and digital subtraction angiography (DSA).
Main Results:
- TCCS revealed characteristic findings in all patients, including saccular vessel enlargement and multicolored flow patterns.
- Spectral analysis demonstrated significantly elevated systolic and diastolic velocities and a low resistance index, indicative of AVMs.
- TCCS successfully identified AVMs in children with headaches, with findings confirmed by advanced imaging techniques.
Conclusions:
- Transcranial color-coded duplex sonography (TCCS) is a valuable, non-invasive, safe, and cost-effective method for detecting cerebral AVMs in children with headaches.
- TCCS facilitates the detection and monitoring of hemodynamic changes associated with AVMs before and after treatment.
- The widespread availability of TCCS makes it an accessible tool for pediatric neurovascular assessment.
Purpose:
Cerebral arteriovenous malformations (AVM) are uncommon lesions. They are most often presented in childhood as intracranial hemorrhage. The aim of this report is to present the use of transcranial color-coded duplex sonography (TCCS) in detection of AVMs in children suffering headache.
Methods:
This report describes five pediatric patients with headache and cerebral AVM which were initially discovered by TCCS. Diagnosis was confirmed by magnetic resonance imaging and digital subtraction angiography.
Results:
In all patients, TCCS showed saccular enlargement of the vessels with a multicolored pattern corresponding to the different directions of blood flow. Spectral analysis showed significantly high flow systolic and diastolic velocities and low resistance index.
Conclusions:
In this report, we describe TCCS as a valuable non-invasive, harmless, low-cost, widely available method for the detection and follow-up of hemodynamic changes of AVMs in children with headache, before and after treatment.
