Intracerebral Venous System: Monitoring by Transcranial Color-Coded Duplex Sonography (TCCS)

Transcranial Doppler and transcranial color-coded duplex sonography (TCCS) have been less utilized for the assessment of the intracerebral venous system although they are widely used imaging modalities for examinations of the cerebral arterial system. This is partially due to early technical limitations of ultrasound systems as well as a low prevalence of clinical cerebral venous disease to evaluate the reliability of these ultrasound technologies. Although venous TCCS is not currently used in routine clinical practice, it has a great potential to be a quick and complementary bedside diagnostic and monitoring modality for the patients with cerebral venous sinus thrombosis, arteriovenous malformations, malignant ischemic stroke, subarachnoid hemorrhage, and instability of intracranial pressure. In this chapter, we review cerebral venous anatomy, venous TCCS investigation technique, and clinical applications of TCCS in the intracerebral venous system.