Transcranial Doppler Sonography

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Abstract
Despite growing interest and a rapidly expanding literature, the clinical usefulness of transcranial Doppler sonography (TCD) has not been universally accepted.1 Imaging modalities such as venous digital subtraction angiography and xenon 133 enjoyed similar initial enthusiasm only to be relegated to limited indications or abandoned because of inaccuracies or impracticalities. Whether TCD will persist as a component of routine evaluations or become another historical footnote remains uncertain. However, an impressive body of evidence suggests an important role for TCD in the evaluation of patients with vasospasm after subarachnoid hemorrhage and in many individuals with ischemic cerebro-vascular disease. The growing list of applications of TCD provides the possibility of other contributions in the future. Because vasospasm is the leading cause of delayed cerebral ischemia and death following subarachnoid hemorrhage, its early and accurate detection is critical for optimal management. Until the introduction of TCD, cerebral angiography was