Transcranial ultrasonography (transcranial doppler, TCD) is a generally underused ultrasound application despite its relative simplicity, low inter-observer variability and a steep learning curve. A typical flow pattern on TCD is an accepted method for confirmation of irreversible brain death prior to organ donation according to the current Czech law.
However, TCD in this indication has to be performed by a competent specialist in radiology, neurology, neurosurgery or paediatric neurology with minimum 3 years of proven experience with TCD. Despite this specific competency problem of brain death confirmation, TCD remains a valuable method for estimation of progression of intracranial hypertension to brain death and helps with the timely application of other confirming methods for the routine ICU ultrasound user.