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Updated: Jul 31, 2025
Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Transcranial doppler velocities in a large healthy population of African children
Nicole F O'Brien1, Hunter C Johnson1, Davin Ambitapio Musungufu2
1Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43502, USA.
Insights
This study establishes crucial reference values for transcranial doppler ultrasound (TCD) in African children, improving diagnostic accuracy for cerebrovascular conditions. These new TCD values are essential for pediatric care in Africa.
Area of Science:
- Pediatric Neurology
- Vascular Ultrasound
- Neurosonology
Background:
- Transcranial Doppler (TCD) ultrasound is vital for diagnosing cerebrovascular conditions.
- Interpreting pediatric TCD requires age-matched normative data, which is lacking for African children.
- TCD use is increasing in Africa due to limited neuroimaging alternatives.
Purpose of the Study:
- To establish reference values for cerebral blood flow velocities (CBFVs) using TCD in healthy African children.
- To address the absence of normative TCD data in this specific pediatric population.
Main Methods:
- A prospective study included 710 healthy African children aged 3 months to 15 years.
- Standardized TCD examinations were performed, measuring systolic, diastolic, and mean flow velocities, and pulsatility index.
- Demographic, vital sign, and hemoglobin data were collected.
Main Results:
- Cerebral blood flow velocities (CBFVs) increased with age, peaking between 5-5.9 years.
- Few significant gender-based differences in CBFVs were observed.
- CBFVs in children aged ≥3 years were significantly lower than previously published data, except in the youngest age groups.
Conclusions:
- This study provides the first reference TCD values for African children.
- Implementing these normative values will enhance the accuracy of TCD diagnostics in African pediatric populations.
- Improved TCD interpretation can lead to better clinical management of cerebrovascular diseases in the region.
Background And Purpose:
Transcranial doppler ultrasound (TCD) is a tool that diagnoses and monitors pathophysiological changes to the cerebrovasculature. As cerebral blood flow velocities (CBFVs) increase throughout childhood, interpretation of TCD examinations in pediatrics requires comparison to age matched normative data. Large cohorts of healthy children have not been examined to develop these reference values in any population. There is a complete absence of normative values in African children where, due to lack of alternate neuroimaging techniques, utilization of TCD is rapidly emerging.
Materials And Methods:
A prospective study of 710 healthy African children 3 months-15 years was performed. Demographics, vital signs, and hemoglobin values were recorded. Participants underwent a complete, non-imaging TCD examination. Systolic (Vs), diastolic (Vd), and mean (Vm) flow velocities and pulsatility index (PI) were calculated by the instrument for each measurement.
Results:
Vs, Vd, and Vm increased through early childhood in all vessels, with the highest CBFVs identified in children 5-5.9 years. There were few significant gender differences in CBFVs in any vessels in any age group. No correlations between blood pressure or hemoglobin and CBFVs were identified. Children in the youngest age groups had CBFVs similar to those previously published, whereas nearly every vessel in children ≥3 years had significantly lower Vs, Vd, and Vm.
Conclusions:
For the first time, reference TCD values for African children are established. Utilization of these CBFVs in the interpretation of TCD examinations in this population will improve the overall accuracy of TCD as a clinical tool on the continent.
