Sharma Vijay K, Venketasubramanian N, Khurana Dheeraj K, Tsivgoulis Georgios, Alexandrov Andrei V
National University Hospital,, Singapore.
National Neuroscience Institute,, Singapore.
Ann Indian Acad Neurol. 2008 Jan;11(Suppl 1):S39-S51.
Transcranial Doppler (TCD) ultrasonography is the only noninvasive examination that provides a reliable evaluation of intracranial blood flow patterns in real-time, adding physiological information to the anatomical information obtained from other neuroimaging modalities. TCD is relatively cheap, can be performed bedside, and allows monitoring both in acute emergency settings as well as over prolonged periods; it has a high temporal resolution, making it ideal for studying dynamic cerebrovascular responses.
To define the role of TCD in the evaluation of patients with acute ischemic stroke.
We have analyzed the existing literature on the protocols for performing TCD in the evaluation of patients with acute cerebral ischemia. Extended applications of TCD in enhancing intravenous thrombolysis in acute stroke, emboli monitoring, right-to-left shunt detection, and vasomotor reactivity have also been described.
In acute cerebral ischemia, TCD is capable of providing rapid information about the hemodynamic status of the cerebral circulation, monitoring recanalization in real-time and, additionally, has a potential for enhancing tissue plasminogen activator (TPA)-induced thrombolysis. Extended applications of TCD make it an important and valuable tool for evaluating stroke mechanisms, for planning and monitoring treatment, and for determining prognosis.
TCD has an established clinical value in the diagnostic workup of stroke patients and is suggested as one of the essential components of a comprehensive stroke center. TCD is also an evolving ultrasound method with increasing diagnostic value and a therapeutic potential in cerebral ischemia.
经颅多普勒（TCD）超声检查是唯一能够实时可靠评估颅内血流模式的无创检查，可为从其他神经影像学检查获得的解剖学信息增添生理学信息。TCD相对便宜，可在床边进行，既适用于急性紧急情况的监测，也适用于长期监测；它具有较高的时间分辨率，是研究动态脑血管反应的理想选择。
明确TCD在急性缺血性脑卒中患者评估中的作用。
我们分析了现有关于在急性脑缺血患者评估中进行TCD检查方案的文献。还描述了TCD在增强急性卒中静脉溶栓、栓子监测、右向左分流检测和血管舒缩反应性方面的扩展应用。
在急性脑缺血中，TCD能够快速提供有关脑循环血流动力学状态的信息，实时监测再通情况，此外，还具有增强组织纤溶酶原激活剂（TPA）诱导溶栓的潜力。TCD的扩展应用使其成为评估卒中机制、规划和监测治疗以及判断预后的重要且有价值的工具。
TCD在卒中患者的诊断检查中具有公认的临床价值，被建议作为综合卒中中心的重要组成部分之一。TCD也是一种不断发展的超声检查方法，在脑缺血方面的诊断价值和治疗潜力不断增加。
