Brain ultrasonography: methodology, basic and advanced principles and clinical applications. A narrative review

Intensive Care Med. 2019 Jul;45(7):913-927. doi: 10.1007/s00134-019-05610-4. Epub 2019 Apr 25.


Brain ultrasonography can be used to evaluate cerebral anatomy and pathology, as well as cerebral circulation through analysis of blood flow velocities. Transcranial colour-coded duplex sonography is a generally safe, repeatable, non-invasive, bedside technique that has a strong potential in neurocritical care patients in many clinical scenarios, including traumatic brain injury, aneurysmal subarachnoid haemorrhage, hydrocephalus, and the diagnosis of cerebral circulatory arrest. Furthermore, the clinical applications of this technique may extend to different settings, including the general intensive care unit and the emergency department. Its increasing use reflects a growing interest in non-invasive cerebral and systemic assessment. The aim of this manuscript is to provide an overview of the basic and advanced principles underlying brain ultrasonography, and to review the different techniques and different clinical applications of this approach in the monitoring and treatment of critically ill patients.

Keywords: Brain ultrasonography; Neurosonology; Optic nerve sheath diameter; Transcranial Doppler.

Publication types

  • Systematic Review

MeSH terms

  • Blood Flow Velocity / physiology
  • Brain / diagnostic imaging*
  • Brain Death / diagnostic imaging
  • Brain Diseases / diagnosis
  • Brain Diseases / diagnostic imaging*
  • Cerebrovascular Circulation / physiology
  • Critical Care / methods*
  • Emergency Service, Hospital / organization & administration
  • Humans
  • Intensive Care Units / organization & administration
  • Intracranial Pressure / physiology
  • Point-of-Care Systems / organization & administration
  • Ultrasonography / methods*
  • Ultrasonography, Doppler, Transcranial / methods