Cerebral Hypoperfusion Management in Neurocritical Care: The Potential of TCD-Guided Interventions

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Transcranial Doppler (TCD) can estimate absolute cerebral perfusion pressure (CPP) in cases of intracranial hypertension or arterial hypotension.
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TCD analysis of waveform parameters like Pulsatility index (PI) and Diastolic velocity (Vdia) helps assess CPP adequacy.
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TCD-guided resuscitation strategies can normalize cerebral perfusion parameters in comatose patients, potentially improving prognosis.
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The Czosnyka method integrates TCD measurements with systemic blood pressure to accurately assess intracranial pressure (ICP) and CPP.
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Normal TCD findings do not exclude elevated ICP, necessitating careful interpretation alongside systemic blood pressure assessments.

Critical Care

by Anselmo Caricato, Camilla Gelormini, Luca Pisapia, Angela Scavone, Melania Cesarano, Valentina Giammatteo
October 5, 2026

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