In the scope of therapeutic ultrasound applications in the adult brain, such as sonothrombolysis in stroke, a better understanding of the intracranial acoustic properties during insonation through the temporal bone is warranted. Innovative ultrasound imaging techniques, like transcranial duplex sonography, may open new avenues to apply ultrasound for therapeutic purposes and to visually monitor the effect using the same device. The aim was to study the transcranial sound field aberrations and the changes of acoustic parameters, using a high-end duplex machine. Six cadaver skulls were insonated through the temporal bone window, using a diagnostic duplex ultrasound device. The measurements were done in a water tank, using a needle hydrophone to assess and compute acoustic parameters, such as peak intensity, peak-to-peak, peak-positive, peak-negative acoustic pressure, beam area etc. in a 2-D plane. It could be shown that the absorption and wavefront distortion effects of the temporal bone are variable among different skulls. Because of signal absorption of the bone, the mechanical index of the incident ultrasound wave drops by a factor > or =10 in most cases. However, the beam area might be increased by a factor of almost 4, because of phase aberration (i.e., defocusing). (