It's normal to feel a little scared and nervous when your doctor tells you to do a brain scan. You might think, "What happened?" But this scan, called a transcranial Doppler, is nothing to be afraid of. Simply put, it's a very safe test, just like an ultrasound scan done on a pregnant mother to check on her baby.
Simply put, what is Transcranial Doppler?
This is a method that uses sound waves to check the blood flow through the blood vessels in your brain. Just like checking to see if there is traffic on the road, whether cars are speeding, or whether they are moving slowly, this scan allows the doctor to see how the blood is moving through the blood vessels in your brain.
This is used to diagnose cerebrovascular diseases and to monitor the results of certain treatments.
Why would a doctor recommend this scan?
Imagine that someone is constantly dizzy, suddenly unable to speak, or has symptoms like numbness in their limbs. At times like these, the doctor may suspect that there is some problem with the blood circulation in the brain. That is when this scan becomes very important.
See the table below for the main medical conditions this test can help diagnose.
| Diagnosable medical condition | A simple explanation |
|---|---|
| Narrowing of blood vessels in the brain (Stenosis) | Narrowing of the blood vessels from the inside due to deposits of cholesterol (atherosclerosis). |
| Risk of stroke | To see how much stroke risk there is, especially for people with diseases like sickle cell anemia. |
| Transient ischemic attack (TIA) | Like a 'mini-stroke', it's a situation where the blood flow to the brain stops for a few minutes. |
| Blood clots from the heart (embolism) | To see if a small blood clot that forms in the heart breaks off and gets stuck in a vein in the brain. |
| Cerebral aneurysm | To see if there is a weakening of the wall of a blood vessel in the brain and a balloon-like bulge. |
| Vasospasm | To see if blood vessels suddenly constrict after a condition such as a stroke. |
| Confirmation of Brain Death | To confirm that there is no blood supply to the brain at all. |
How does this scan work?
What happens here is very simple. The scanning device sends sound waves through the tissues of your skull. These sound waves hit the blood vessels in the brain, hit the fast-moving blood cells in it, and come back as echoes. The doctor uses a computer screen to look at the speed and direction of the returning sound waves to draw conclusions about the blood flow in the brain.
Do I need to prepare before the scan?
No, this doesn't require any special preparation. You won't need to wear a hospital gown or take off your jewelry.
However, if you wear contact lenses, you may be asked to remove them before the test. Also, if you wear a head covering, the technician conducting the test will discuss with you how to temporarily remove or change it. You will be given the privacy you need to do so.
What happens during the scan?
The method of doing this test is very simple.
- First, you will be made to lie down on an examination bed or sit in a chair.
- Then, the technician will apply a water-based gel to your skin, where it will be tested. This gel is usually applied to the back or front of your neck, above your cheekbones, in front of your ears, or above your eyelids. This is because these are the main blood vessels that supply blood to your brain. This gel is gentle on your skin and won't stain your clothes.
- Next, a small pen-like device (called a transducer ) is moved back and forth over the gel. This device sends sound waves into the brain and picks up the waves that return.
- At this time, your brain's blood flow is displayed on the computer screen, either as graphs or as color images.
- The most important thing is that you should not move your head or talk during this test.
- When the test is finished, the applied gel is wiped off.
Sometimes, an IV line may be placed in a vein in your arm and saline may be injected through it. This is done to check for a hole in your heart that could allow a blood clot to travel to your brain.
Does this hurt? How long will it take?
It doesn't hurt at all. There's no discomfort, no pain. You may feel a little cold when you rub the gel. You'll feel a little pressure when you move the device (transducer) over your skin, that's all.
This scan usually takes between 30 and 60 minutes , depending on the type of test you have been prescribed.
What happens after the test? Let's learn about the results.
Once the test is over, you can go home the same day. Since this is not harmful to the body, there is no problem in driving a vehicle or doing your usual activities.
As for the results, they can be obtained soon after the test. Your doctor may discuss the results with you on the same day. Or they may schedule a separate day for it.
There can be two types of results:
- Normal results: This means that there are no problems with the blood flow to and within your brain, and everything is going well.
- Abnormal results: This means that a blood vessel that supplies blood to the brain may be blocked, narrowed, or otherwise obstructed. This could indicate something like a blood clot coming from the heart (embolism) or a hole in the heart (PFO).
If you get an abnormal result, don't panic. It means your doctor can now diagnose your condition and start the right treatment. He or she may also order another test to find out more.
Take-Home Message
- Transcranial Doppler is a completely painless, safe ultrasound scan that looks at blood flow in the blood vessels of the brain.
- No special preparation is required for this, and no radioactive rays like X-rays are used.
- This is very helpful in early detection of serious conditions such as stroke risk and narrowing of blood vessels.
- After the test, you can continue working as usual.
- Whatever the results, don't be afraid to talk openly with your doctor about it and get advice on what to do next.
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