![]() ![]() ![]() There are numerous variations to this classic anatomy, many of which cause an incomplete circle. The circle is completed via connections of the distal ICAs to the PCAs via the posterior communicating arteries, and the bilateral ACAs are connected via the anterior communicating artery. The basilar artery then bifurcates into the bilateral posterior cerebral arteries. The basilar artery gives off distinct branches, including the anterior inferior cerebellar artery (AICA), pontine perforating arteries, and the superior cerebellar arteries. The posterior circulation is supplied by the vertebral arteries, which join to form the basilar artery. The anterior circulation is largely provided by the ICAs, which branch intracranially into the middle cerebral and anterior cerebral arteries. The Circle of Willis is an anastomotic ring of vessels that supply the brain. These extracranial vessels supply the Circle of Willis, named after Thomas Willis, an English physician. The intracranial arteries are supplied by the vertebral and the bilateral internal carotid arteries. This article will focus on these common indications. Common indications for TCD include screening for vasospasm in patients with subarachnoid hemorrhage, screening for signs of angiopathy in pediatric sickle cell disease patients, and evaluation for a right-to-left shunt in the setting of stroke and suspected paradoxical embolism (patent foramen ovale and other pathologies). Various vascular measurements can be determined, including cerebral blood flow velocity, which can affect many different pathologies. This technique takes advantage of acoustic windows present in the skull to interrogate the intracranial vascular structures. Transcranial Doppler (TCD) is a non-invasive ultrasound technique, not utilizing ionizing radiation. Outline the importance of TCD exam in the screening of pediatric sickle cell disease patients.Summarize the basic technique of transcranial Doppler examination.Describe transcranial Doppler findings associated with vasospasm in subarachnoid hemorrhage patients.Identify common indications for transcranial Doppler examination.This activity reviews a few examples of transcranial Doppler exam indications, basic techniques, and the importance these findings have in clinical care by the interprofessional team. It offers a non-invasive, radiation-free way to monitor for sequelae from subarachnoid hemorrhage or to help determine stroke risk in sickle cell patients. Transcranial doppler is utilized to investigate the intracranial vasculature for various purposes. ![]()
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