Transcranial doppler methods in the assessment of cerebral vasomotor reactivity

Introduction. Transcranial Doppler is the only non-invasive neuroimaging modality in the diagnosis and monitoring of various neurovascular diseases. Apart from assessing cerebral hemodynamics of blood flow in the basal brain arteries, transcranial Doppler provides physiological data and anatomical images. Quantification analysis of vasomotor reactivity. Various transcranial Doppler methods evaluate cerebral vasomotor reactivity, providing important information on the properties of arterioles under induced hemodynamic conditions. Exogenous and endogenous vasoactive stimuli of different potency (apnea, acetazolamide, carbon dioxide, L-arginine) are most commonly used, making transcranial Doppler a prognostic indicator of future ischemic events. This article reviews principles of various transcranial Doppler methods in the evaluation of vasomotor reactivity, emphasizing their advantages and disadvantages. Transcranial Doppler in the field of reduced vasomotor reactivity. Evaluation of vasomotor reactivity has a role in the prediction of future ischemic events, evaluation of revascularization effect after carotid endarterectomy, but also in the increasingly significant choice of the right time to perform it. In recent years, transcranial Doppler methods have found application in other areas of dysfunctional cerebral hemodynamics: dementia, hypertension, migraines, and sepsis. Conclusion. Due to an excellent temporal resolution, non-invasive approach, good cost-benefit ratio, bedside monitoring, relative simplicity in terms of interpretation and performance, and portability, transcranial Doppler in vasomotor reactivity may be the ideal tool in the evaluation of cerebral hemodynamics, arterial perfusion integrity and collateral capacity.