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Abstract Traumatic brain injury (TBI) is a common cause of mortality and disability worldwide. More than 80% of TBI cases presenting to ER are classified as mild to moderate. TCD is a technique that explores cerebral blood flow velocities. It is a relatively low-cost, risk-free, bedside available, and high temporal resolution device, it is also suitable for the emergency setting. Our study conducted on 105 patients with mild and moderate TBI to predict early SND in 1st week following trauma. Each patient underwent TCD on admission to detect PI of middle cerebral artery. Our results concluded the role of TCD in prediction of SND in mild and moderate TBI (with threshold 1.21 for PI and 25 cm/s for FVd) with good sensitivity and specificity. TCD is a good negative test in patients with mild lesion in initial CT. Also, PI on admission had a negative correlation with GOSE at 1 month after trauma in mild and moderate TBI. TCD on admission may provide a valuable tool of early and after 1 month prediction of neurological outcome for mild and moderate TBI patients. Closing the gap in poor prediction of commonly used evaluation by CT especially with mild lesion. The significant limitations to the clinical utility of TCD in TBI include operator dependency and in patients who lack an adequate acoustic temporal window for insonation. Our recommendations, to evaluate positive predictive value of TCD in these categories of patients, many studies with large sample size may be needed. Also, standardization for usage of TCD in ER for all TBI with different degrees and its correlation to predict morbidity and mortality of all degrees of TBI is recommended. |