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Transcranial Doppler ultrasound

Show Alternative Names
Transcranial Doppler ultrasonography
TCD ultrasonography
TCD
Transcranial Doppler study

Transcranial doppler ultrasound (TCD) is a diagnostic test. It measures blood flow to and within the brain.

How the Test is Performed

TCD uses sound waves to create images of the blood flow inside the brain.

This is how the test is performed:

  • You lie on your back on a padded table with your head and neck on a pillow. Your neck is stretched slightly. Or you may sit on a chair.
  • The technician applies a water-based gel on your temples and eyelids, under your jaw, and at the base of your neck. The gel helps the sound waves get into your tissues.
  • A wand, called a transducer, is moved over the area being tested. The wand sends out sound waves. The sound waves go through your body and bounce off the area being studied (in this case, your brain and blood vessels).
  • A computer looks at the pattern that the sound waves create when they bounce back. It creates a picture from the sound waves. The Doppler creates a "whooshing" sound, which is the sound of your blood moving through the arteries and veins.
  • The test can take 30 minutes to 1 hour to complete.

How to Prepare for the Test

No special preparation is needed for this test. You do not need to change into a medical gown.

Remember to:

  • Remove contact lenses before the test if you wear them.
  • Keep your eyes closed when gel is applied to your eyelids so you don't get it in your eyes.

How the Test will Feel

The gel may feel cold on your skin. You may feel some pressure as the transducer is moved around your head and neck. The pressure should not cause any pain. You may also hear a "whooshing" sound. This is normal.

Why the Test is Performed

The test is done to detect conditions that affect blood flow to the brain:

  • Narrowing or blockage of the arteries in the brain
  • Stroke or transient ischemic attack (TIA)
  • Bleeding in the space between the brain and the tissues that cover the brain (subarachnoid hemorrhage)
  • Ballooning of a blood vessel in the brain (cerebral aneurysm)
  • Change in pressure inside the skull (intracranial pressure)
  • Sickle cell anemia, to assess stroke risk

Normal Results

A normal report shows normal blood flow to the brain. There is no narrowing or blockage in the blood vessels leading to and within the brain.

What Abnormal Results Mean

An abnormal result means an artery may be narrowed or something is changing the blood flow in the arteries of the brain.

Risks

There are no risks with having this procedure.

Review Date: 4/29/2023

Reviewed By

Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Defresne A, Bonhomme V. Multimodal monitoring. In: Prabhakar H, ed. Essentials of Neuroanesthesia. Cambridge, MA: Elsevier Academic Press; 2017:chap 9.

Ellis JA, Yocum GT, Ornstein E, Joshi S. Cerebral and spinal cord blood flow. In: Cottrell JE, Patel P, eds. Cottrell and Patel's Neuroanesthesia. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 2.

Matta B, Czosnyka M. Transcranial doppler ultrasonography in anesthesia and neurosurgery. In: Cotrell JE, Patel P, eds. Cottrell and Patel's Neuroanesthesia. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 7.

Newell DW, Monteith SJ, Alexandrov AV. Diagnostic and therapeutic neurosonology. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 410.

Sharma D, Prabhakar H. Transcranial Doppler ultrasonography. In: Prabhakar H, ed. Neuromonitoring Techniques. Cambridge, MA: Elsevier Academic Press; 2018:chap 5.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Atherosclerosis of internal carotid artery - Illustration Thumbnail

Atherosclerosis of internal carotid artery

The build-up of plaque in the internal carotid artery may lead to narrowing and irregularity of the artery's lumen, preventing proper blood flow to the brain. More commonly, as the narrowing worsens, pieces of plaque in the internal carotid artery can break free, travel to the brain and block blood vessels that supply blood to the brain. This leads to stroke, with possible paralysis or other deficits.

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Endarterectomy

Endarterectomy is a surgical procedure removing plaque material from the lining of an artery.

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Weakness, numbness, or other loss of nerve function may indicate that an aneurysm may be causing pressure on adjacent brain tissue. Symptoms such as a severe headache, nausea, vomiting, vision changes or other neurological changes can indicate the aneurysm has ruptured and is bleeding into the brain. A ruptured intracranial aneurysm causes intracranial bleeding and is considered very dangerous.

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Transient Ischemic attack (TIA) - Illustration Thumbnail

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