Transcranial color-coded duplex ultrasonography in routine cerebrovascular diagnostics

Transcranial color-coded duplex ultrasonography (TCCS) enables the visualization of basal cerebral arteries through the intact skull by color-coding of blood flow velocity. The arteries of the circle of Willis can be identified by their anatomic location with respect to the brain stem structures and by the determination of the flow direction. TCCS is an important neuroimaging method due to its excellent time resolution. In addition to the diagnostics of intracranial vascular disease, this technique is valuable in intensive care and stroke units, e.g. for follow-up examinations in vasospasm after subarachnoid hemorrhage, and for intraoperative monitoring as well. In difficult anatomical conditions, the application of echo contrast agents can improve the diagnostic reliability of the examination. This paper reviews the examination technique and the clinical application of this method in routine cerebrovascular diagnostics.