Abstract
The Code Stroke designation was implemented in the 1990's to insert time urgency in treating stroke patients with intravenous or intra-arterial tissue plasminogen activator (t-PA). This drug can fragment the intracranial arterial thrombus before the advent of permanent brain damage (3 hours after symptom onset) in roughly 20% of Code Stroke patients. Fragmentation and resolution of intra-arterial thrombus is a dynamic process. Transcranial Doppler (TCD) is uniquely positioned to monitor these changes as they occur. Five unique TCD waveforms have been isolated that commonly occur during and after a stroke. A registered vascular sonographer should be able to rapidly obtain and recognize these waveforms.
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