Transcranial Doppler Ultrasound Use in Pediatric Traumatic Brain Injury

Transcranial Doppler (TCD) ultrasound is an inexpensive portable diagnostic tool commonly available within most health care 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 (TBI). 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 two 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. TCD 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 multidynamic nature of the injury, and TCD has the ability to support these efforts.