Transcranial Doppler sonography is a noninvasive method of obtaining information about changes in cerebral hemodynamics and intracranial pressure. After severe head injuries the development of brain swelling and brain edema can be assessed and the efficacy of treatment monitored. Development of severe brain edema accompanied by a rapid increase in intracranial pressure can be recognized by a decrease in blood flow velocity and rise in the pulsatility index. In hydrocephalic children the behavior of the cerebral blood flow velocity and the pulsatility index will warn of an increase of the ventricular fluid pressure or a shunt insufficiency.

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