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It is important to understand proper transducer positioning, anatomic landmarks, and appropriate scale settings. A standard TCD examination technique through temporal, orbital, suboccipital, and submandibular window is proposed in this review article. To shorten the time of examination, maximum power and large sample volume are recommended. It is crucial to perform a complete and through examination, although the examiner should target clinically involved arterial segment or suspected level of occlusion. Once the highest signal is found, avoid losing signal during switching the depth of insonation. Recent studies have reported diagnostic and prognostic value of TCD waveform in acute stroke. Thrombolysis In Brain Infarction(TIBI) flow grade classifies waveform as absent, minimal, blunted, dampened, stenotic, and normal. TIBI represents the residual blood flow, and is well correlated with recanalization and early stroke outcome. Definition of each flow grade is introduced in this article. Recently developed new TCD machine adopts power motion mode(M-mode) Doppler, which provides a vascular ?oad map?through the acoustic window. It came to be easier to perform the TCD examination. In the future, more compact and easier-to-use machine will be developed, and TCD is expected to be a true ?erebral stethoscope?
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