Alex Razumovsky

Dear all, Transcranial Doppler (TCD) ultrasound is a quantitative ultrasound test that measures linear blood flow velocity in cm/sec through the major brain vessels. TCD major utilization are for patients with cerebrovascular diseases and traumatic brain injury because with TCD you can detect abnormalities of brain blood flow that could be associated with vessels disease, like stenosis/narrowing/occlusion, presence of post-traumatic or post-TBI vasospasm or decreased brain blood flow due to the onset of abnormally high ICP or presence of intracranial hypertension. US Army/AMEDD TBI TCD program that started in Oct. 2008 provides TCD services currently at Navy National Medical Center (Bethesda, MD), Walter Reed Army Med. Center (Washington, DC) and Brooke Army Military Med. Center (San Antonio, TX). Clinical value and utilization of TCD for patients after traumatic brain injury, after aneurysm rupture, in patients with sickle cell disease, patients with arteriovenous malformation, ischemic stroke is well established and validated in numerous papers. TCD value for patients with migraine is not so well documented and investigations still must be done. However, there are very interesting observational studies that suggesting certain limk between migraine and so-called Patent Foramen Ovale or abnormal right-to-left cardiac shunt. Alex Razumovsky