Happy to share that we have successfully conducted India's first World Organisation of Neurosonology (WON) endorsed workshop on Neurosonology in Acute Care at Symbiosis University Hospital & Research Centre, Pune, India. This is just the beginning. Soon, every intensivist will be empowered with the skills of bedside Neurosonology. A privilege to work with Dr Vivek sir, Dr Suchitra mam, Dr Amol Kothekar sir, Dr Pradeep D Costa sir, Dr Avinash Jha, Dr Richard Cashmore and Dr Sreevatsa for this workshop. 🤝 Honoured to meet Dr Deepak Govil sir at the Workshop 🙏 I thank the organising team of at Symbiosis University Hospital & Research Centre for organising the workshop very well. Looking forward to the Neurosonology workshop at ISACON National 2026 conference in November ✌️ @drvivekkumarmd @RMJCashmore @Dr_AvinashJha @Srivatsa34

Thank you so much @aartisarwal and @Yasaman_Neuro for sharing the proceedings of Neuroultrasound Stroke Care Symposium. Check it here 👇 youtube.com/playlist?list=PL…

Not getting a good transtemporal window? Or are you stuck with only the transtemporal window? 🧠🔍 Looking for an opportunity to explore other insonation windows, techniques, and their clinical applications? We are excited to bring you an immersive Neurosonology Workshop, led by experts in the field! Go beyond routine Transcranial Doppler and broaden your Neurosonology skill set with integrated discussions and hands-on learning covering: 🔹 Transcranial Doppler (TCD) – multiple insonation windows & their applications 🔹 Carotid & Vertebral Doppler – extracranial cerebrovascular assessment 🔹 Optic Nerve Sheath Diameter (ONSD) – integrating Neuro-POCUS into bedside assessment Look beyond the transtemporal window. Explore the full spectrum of Neurosonology. ⚠️ Registrations are limited. For registration and further details, connect with Dr Suchitra Mohite at [email protected]. @Srivatsa34 @Dr_AvinashJha @rmjcashmore

doi.org/10.52211/asra050125.… @schhabra0209 @22sksachin @KalagaraHari

Midline Shift Assessment by Transcranial Color-Coded Duplex Sonography (TCCD) Midline shift (MLS) is an important bedside marker of mass effect and raised intracranial pressure in patients with acute brain injury. Transcranial Color-Coded Duplex Sonography (TCCD) offers a rapid, non-invasive method to estimate MLS by visualising the third ventricle through the transtemporal acoustic window. The technique involves measuring the distance from the outer table of the skull to the centre of the third ventricle from both temporal windows. Midline shift is calculated using the formula: MLS = (A − B) / 2 where A and B represent the right- and left-sided skull-to-third ventricle distances, respectively. In the illustrated case, TCCD estimated a 3.2 mm rightward midline shift, which closely correlated with the CT finding of a 3.5 mm rightward shift caused by a large left hemispheric infarction. Although TCCD is an excellent bedside monitoring tool, clinicians should recognise its limitations. Measurements may be unreliable in patients with decompressive craniectomy, skull fractures, temporal cephalohematoma, or distorted intracranial anatomy following trauma or surgery. The sensitivity and specificity of TCCD in identifying a midline shift for more than 5 mm is 95% and 90% respectively. TCCD does not replace CT imaging, but it serves as a valuable adjunct for serial bedside monitoring and timely neurocritical care decision-making.

Welcome to the 14th post of #scanuary. It's a month-long marathon of daily tweetorials about #POCUS and its utility in our clinical practice. Today we're going to discuss assessment of assessment of stroke using TCCD. If you find the post useful, please like & retweet. @salmannaeem217 @gokpocus

TCD/TCCD - Obstacles and opportunities One of the major obstacles for insonating intracranial arteries is the skull. Ultrasound waves simply couldn't' break the barrier of the bone. Thanks to the experiments by Rune Aaslid, existence of insonation windows were identified. They are essentially thin portions of the skull through which ultrasound waves can penetrate the skull and insonate intracranial arteries. Do read this nice article on basics of Brain POCUS by @RMJCashmore and @Dr_AvinashJha doi.org/10.7759/cureus.10000…