Knowledge of post-traumatic cerebral haemodynamic disturbances might be beneficial for predicting the management outcome when measuring the basal cerebral arteries blood flow velocity by ultrasonic transcranial Doppler device immediately after severe head injury. Thirty patients who sustained severe brain injury underwent an early blood velocity measuring by transcranial Doppler ultrasonography during a 1-year period of study. The standard technique of measuring the mean blood flow velocity in the middle cerebral artery was applied. The outcome was assessed at 6-month follow-up by the Glasgow Outcome Score. The middle cerebral artery low blood flow velocity, and the increased values of the pulsatility index significantly correlated to an unfavourable outcome. Transcranial Doppler ultrasonography for measuring the middle cerebral artery blood flow velocity has been proved worthy as a possible predictor of severe head injury management outcome. This non-invasive and simple procedure could be engaged in the daily management of severely brain-injured patients.