Operative Neurosurgery 29:633–638, 2025
This clinical technical note and case series evaluates real-time Doppler probe navigation during transcranial craniotomy for brain tumor resection, describing technique, operative workflow, and outcomes from 501 operations where the Doppler was used. The authors report a low rate of major vessel injury (<1%) and discuss how Doppler guidance complements neuronavigation and ultrasound as tumor resection progresses and brain shift reduces image accuracy.
The paper details patient selection, surgical approaches, probe specifications and intraoperative use, illustrates three case examples with video, and analyzes stroke and infarction rates attributable to vasospasm or small-vessel injury. Limitations include retrospective design and variable probe penetrance; the authors recommend routine Doppler adjunctive use for tumors encasing or adherent to major arteries.

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