Transcranial Doppler Ultrasound Use in Pediatric Traumatic Brain Injury

Abstract

Transcranial Doppler ultrasound (TCD) is an inexpensive portable diagnostic tool commonly available within most healthcare systems. A team of trained individuals perform and interpret the test to inform patient care management. The benefit of TCD is well established in adult patients with traumatic brain injury. However, in children with TBI, it is still considered exploratory and its use is not a part of the standard of care. This article describes what TCD is, its use in children, and how TCD measurements apply to children and adolescents in an effort to establish criteria for the use of TCD for children with TBI. The benefit of TCD in pediatric TBI is illustrated by 2 cases of children who participated in a TBI research study. Early indications are that the use of TCD in pediatric cases of TBI may produce unexpected real-time data about the cerebral vasculature and circulation characteristics in children with TBI. Transcranial Doppler ultrasound has the potential for playing an informative diagnostic role in future pediatric TBI management. Ultimately the goal to promote best outcomes after a TBI requires insights into the multi-dynamic nature of the injury and TCD has the ability to support these efforts.

Monitoring of Neuroendocrine Changes in Acute Stage of Severe Craniocerebral Injury by Transcranial Doppler Ultrasound Image Features Based on Artificial Intelligence Algorithm

“…Since the hue, saturation, and brightness cannot independently complete the segmentation task when the HSI color space of the region of interest in TCD ultrasound images is segmented, it is necessary to use the similarity threshold (MEAN( S ) a ) method of chromaticity and saturation to preset the ROI region [ 19 ]. The expression is as Equation (8).…”

Cerebral Blood Flow Velocities and Functional Outcomes in Pediatric Mild Traumatic Brain Injury

“…We also observed that abnormal cerebral blood flow velocities occur at a rate similar to children with moderate-to-severe injury, and is most likely underrecognized in pediatric patients of all levels of injury severity. 24 All normative values we used to analyze cerebral blood flow velocity in this patient population are parameters described by LaRovere and O'Brien 27 and Reuter-Rice, 28 and will serve to set the stage for future Common Data Elements for TCD use in children with TBI. Perhaps our findings may prompt the question of a need for larger studies of normative data based on age and gender findings.…”

“…27 The pulsatility index represents a measure of cerebral vascular reactivity; values greater than 1.3 have been independently correlated with poor neurofunctional outcome. 28,29…”

The Effect of the Relationship of APOE Polymorphisms and Cerebral Vasospasm on Functional Outcomes in Children With Traumatic Brain Injury

“…Anterior circulation was defined as the measurement of the right and left middle cerebral artieries (MCA), and posterior circulation was defined as the basilar artery (BA). Our protocol followed the method described by Aaslid, Markwalder, and Nornes (1982) and Lindegaard, Nornes, Bakke, Sorteberg, and Nakstad (1989) where MCA, BA, and extracranial internal carotid arteries (EC-ICAs) were insonated at 2–5 mm intervals (LaRovere & O’Brien, 2015; Reuter-Rice, 2017). Participants underwent a baseline TCD within 24 hr of enrollment in the study and daily TCD examinations through hospital Day 8 or discharge/death.…”