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Over the past 5 years, approximately 30% of patients with severe wartime traumatic brain injury (TBI) experienced cerebral ischemia as a result of the secondary compromise from blast-induced cerebral vasospasm. Transcranial Doppler (TCD) is a noninvasive technique that uses a brain ultrasound to assess and monitor cerebral vascular activities in order to prevent patients from suffering further ischemic injuries to the brain. The U.S. Army Medical Department (AMEDD) TCD Program supports the U.S. Army Surgeon General’s TBI Action Plan and is managed by the U.S. Army Medical Research and Materiel Command’s Telemedicine and Advanced Technology Center (TATRC) in Fort Detrick, Maryland.

The use of TCD can provide accurate blood flow velocity information; assist with following disease progression, therapeutic endovascular or surgical revascularization, and recovery periods; and is low-cost and noninvasive.

Utilizing a central laboratory based in Baltimore, Maryland, the service provides: TCD testing, monitoring, and interpretation; onsite technical support and 24 x 7 x 365 helpdesk; and training and certification. In 2009, the TCD Program successfully completed both phases of its implementation plan, providing services to Walter Reed Army Medical Center (WRAMC), the National Naval Medical Center (NNMC), and the combined San Antonio Military Medical Centers (SAMMC) of Brooke Army Medical Center and Wilford Hall—extending a capacity where previously not available and truly taking a tri-service approach using telehealth capabilities.

Thus far, over 400 TCD studies have been conducted. Preliminary quality review data have indicated that the service has contributed to the pharmacological management of 72% of the patients studied, and have indicated and led to further diagnostic procedures in 18% of the patients, without which they would not have gotten further diagnostic testing. This clearly demonstrates the program’s utility and impact on the management of neurotrauma. Furthermore, the program took top prize in the clinical poster category at the 12th Army Force Health Protection Conference in Albuquerque, N.M., an honor recognizing the importance of the program to our warfighter.

For more information, contact the Public Affairs Office at 301-619-7927 or marketingdirector@tatrc.org.