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Transcranial Doppler for evaluation of cerebral autoregulation

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Abstract

Transcranial Doppler ultrasound (TCD) can measure cerebral blood flow velocity in the main intracranial vessels non-invasively and with high accuracy. Combined with the availability of non-invasive devices for continuous measurement of arterial blood pressure, the relatively low cost, ease-of-use, and excellent temporal resolution of TCD have stimulated the development of new techniques to assess cerebral autoregulation in the laboratory or bedside using a dynamic approach, instead of the more classical ‘static’ method. Clinical applications have shown consistent results in certain conditions such as severe head injury and carotid artery disease. Studies in syncopal patients revealed a more complex pattern due to aetiological non-homogeneity and methodological limitations mainly due to inadequate sample-size. Different analytical models to quantify autoregulatory performance have also contributed to the diversity of results in the literature. The review concludes with specific recommendations for areas where further validation and research are needed to improve the reliability and usefulness of TCD in clinical practice.

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Acknowledgments

The author would like to thank Professor David H. Evans (University of Leicester, UK) for providing the material for Fig. 1 and Dr. Fiona Brodie (Leicester General Hospital, UK), for her suggestions to improve the manuscript.

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  1. Medical Physics Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

    Ronney B. Panerai

  2. Department of Medical Physics, Leicester Royal Infirmary, Leicester, LE1 5WW, UK

    Ronney B. Panerai

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Panerai, R.B. Transcranial Doppler for evaluation of cerebral autoregulation. Clin Auton Res 19, 197–211 (2009). https://doi.org/10.1007/s10286-009-0011-8

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