Thread by @PulmCrit

neuroPOCUS & trans-cranial doppler

- @ottawaheartrob at #HRreloaded

folks figured out trans-cranial doppler using M-mode probes. amazing. this makes me feel really guilty for struggling with a 2D probe.
- @ottawaheartrob at #HRreloaded

relevant anatomy - imaging parallel to the base of the brain, looking at the circle of willis
- @ottawaheartrob at #HRreloaded

2D imaging through the temporal bone
- @ottawaheartrob at #HRreloaded

first find the mid-brain, then zoom in and add doppler. Then move to spectral doppler.
- @ottawaheartrob at #HRreloaded

different arteries have variable normal values for flow and pulsatility
- @ottawaheartrob at #HRreloaded

transcranial doppler may be useful to detect vasospasm in SAH
- @ottawaheartrob at #HRreloaded

absence of diastolic flow occurs if the ICP is equal to the diastolic blood pressure.
- @ottawaheartrob at #HRreloaded

doppler flow *reversal* occurs if the ICP is greater than diastolic blood flow. this is seen in brain death
- @ottawaheartrob at #HRreloaded

optic nerve sheath diameter may be used to determine ICP. note very nuanced understanding of eye anatomy, paging @DGlaucomflecken
- @ottawaheartrob at #HRreloaded