Utility of Transcranial Doppler in Moderate and Severe Traumatic Brain Injury: A Narrative Review of Cerebral Physiologic Metrics

J Neurotrauma. 2021 Aug 15;38(16):2206-2220. doi: 10.1089/neu.2020.7523. Epub 2021 Mar 1.

Abstract

Since its creation in the 1980s, transcranial Doppler (TCD) has provided a method of non-invasively monitoring cerebral physiology and has become an invaluable tool in neurocritical care. In this narrative review, we examine the role TCD has in the management of the moderate and severe traumatic brain injury (TBI) patient. We examine the principles of TCD and the ways in which it has been applied to gain insight into cerebral physiology following TBI, as well as explore the clinical evidence supporting these applications. Its usefulness as a tool to non-invasively determine intracranial pressure, detect post-traumatic vasospasm, predict patient outcome, and assess the state of cerebral autoregulation are all explored.

Keywords: cerebral autoregulation; multi-modal monitoring; transcranial doppler; traumatic brain injury.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Injuries, Traumatic / diagnostic imaging*
  • Brain Injuries, Traumatic / physiopathology*
  • Cerebrovascular Circulation / physiology
  • Humans
  • Intracranial Pressure / physiology
  • Ultrasonography, Doppler, Transcranial*