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The Big No-No That You May Not Know for Transcranial Doppler Imaging (TCDI)

Transcranial Doppler imaging can be a challenging exam for the sonographer to perform on the stoke inpatient. Small rooms, lots of equipment, lots of “lines” and often patient bandages. Many of these factors we have no control over, and we have to adjust our scanning accordingly. But the one no-no you may not know is not to move the bed or the patient. It could be catastrophic and life threatening for the patient. Why? Let me explain….

Some background first:
Approximately 30,000 hemorrhagic strokes occur annual, with over 50% of those patients not making it to the hospital and dying within just minutes. If the patient does make it to the hospital, obtains the needed CTA/MRA for diagnosis and is able to tolerate the coiling of the aneurysm, they still have a 50-70% chance of intracranial vessel vasospasm1 which carries with it a 15-20% risk of another stroke or even death. Though the patient may seem to be doing better after the coiling, it is not until day 3-14 where the manifestations of vasospasm may occur. That is why a baseline (day after coiling) is so important to obtain, as the effects (vasospasms) caused by blood extravasation have not yet occurred. This baseline will aide in later detection of the severity of vasospasm and treatment. Why vasospasms and why that late?                  To learn more, download the free PDF.