title: Transcranial Doppler identifies a malfunctioning extraventricular drain.
abstract: Transcranial Doppler (TCD) is an invaluable tool allowing real-time monitoring of physiologic blood flow velocity changes. We present a case where TCD monitoring for vasospasm after subarachnoid hemorrhage identified blood flow velocity changes consistent with sudden increased intracranial pressure (ICP) due to a malfunctioning extraventricular drain. The primary team was alerted to these findings, and immediately revised her shunt with normalization of ICP and TCD. Serial TCD monitoring allowed identification of an imminently fatal complication in time to allow a life saving intervention. TCD is a portable, inexpensive, real-time tool providing important physiologic data regarding blood flow velocities and intracranial pressure that is crucial to the care of critically ill patients.
authors.affiliation: From the Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, 27517.
authors.forename: David R
authors.initials: DR
authors.lastname: Mayans
authors.forename: Dana B
authors.initials: DB
authors.lastname: Meads
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Reynolds
mesh_terms: D002552:Cerebral Ventricles / Q000000981:diagnostic imaging* / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
keywords: Transcranial Doppler; extraventricular drain; intra-cranial pressure