M. Mijajlovic
Neurology Clinic, Clinical Center of Serbia and School of Medicine University of Belgrade – Belgrade, Serbia

Transcranial Doppler (TCD) is a relatively new, non-invasive tool, allowing for bedside monitoring to determine flow velocities indicative of changes in vascular caliber.
It has been frequently employed for the clinical evaluation of cerebral vasospasm following subarachnoid hemorrhage (SAH). To a lesser degree, TCD has also been used to evaluate cerebral autoregulatory capacity, monitor cerebral circulation during cardiopulmonary bypass and carotid endarterectomy, to diagnose brain death and for monitoring of cerebral hemodynamics in neurotrauma.
TCD is a suitable bedside method for daily assessment of the changes of intracranial pressure (ICP) by continuous monitoring of the changes of blood flow velocities and pulsatility index (PI), reflecting decreases in cerebral perfusion pressure due to increases in ICP.
Growing body of literature demonstrates the usefulness of transbulbar B-mode sonography of the optic nerve for detecting increased ICP in patients requiring neurocritical care.