Advertisement
Original communication| Volume 79, ISSUE 5, P577-580, May 1976

Download started.

Ok

Limitations of the Doppler cerebrovascular examination in hemispheric cerebral ischemia

  • George E. Bone
    Affiliations
    From the Peripheral Vascular Laboratories, University of Iowa and Veterans Administration Hospitals, Iowa City, Iowa, USA
    Search for articles by this author
  • Robert W. Barnes
    Correspondence
    Reprint requests: Robert W. Barnes, M.D., Division of Thoracic and Cardiovascular Surgery, University of Iowa Hospitals, Iowa City, Iowa 52242.
    Affiliations
    From the Peripheral Vascular Laboratories, University of Iowa and Veterans Administration Hospitals, Iowa City, Iowa, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The results of a directional Doppler ultrasound cerebrovascular examination were compared with arteriographic findings in 56 patients with resolved hemispheric strokes or transient ischemic attacks. Aortic arch arteriography revealed appropriate internal carotid artery lesions which were amenable to endarterectomy in 36 patients (64 percent). Of this group, abnormal Doppler findings were present in only 11 patients (31 percent). The definitive clinical applications of the Doppler cerebrovascular examination are limited to those settings in which demonstration of altered hemodynamics is decisive. In view of the apparent preponderance of embolic rather than hemodynamic mechanisms in the pathogenesis of focal cerebral ischemia, the Doppler examination has only an adjunctive role in the evaluation of most patients with hemispheric symptoms of cerebrovascular occlusive disease. In such patients, preselection of candidates for diagnostic arteriography is an inappropriate application of the Doppler cerebrovascular examination.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Blaisdell F.W.
        • Glickman M.
        • Trunkey D.D.
        Ulcerated atheroma of the carotid artery.
        Arch. Surg. 1974; 108: 491
        • Brinker R.A.
        • Landiss D.J.
        • Croley T.F.
        Detection of carotid artery bifurcation stenosis by Doppler ultrasound.
        J. Neurosurg. 1968; 29: 143
        • Brockenbrough E.C.
        Screening for the prevention of stroke: Use of the Doppler flowmeter.
        Alaska Regional Medical Program brochure, Washington1970
        • Brockenbrough E.C.
        • Lawrence C.
        • Schwenk W.G.
        Ocular plethysmography: A new technique for the evaluation of carotid obstructive disease.
        Rev. Surg. 1967; 24: 299
        • Buillart P.
        La pression arterielle clans les branches de l'artère centrale de la rétine; nouvelle technique pour la déterminer.
        Ann. Oculist (Paris). 1917; 154: 648
        • Haas W.K.
        • Fields W.S.
        • North R.R.
        • et al.
        Joint study of extracranial arterial occlusion. II. Arteriography, techniques, sites, and complications.
        J. A. M. A. 1968; 203: 961
        • Janeway R.
        • Maynard C.D.
        • Witcofski R.L.
        Radioisotope arteriography: A new diagnostic technique for evaluation of cerebrovascular disease.
        Circulation. 1968; 38: 139
        • Kartchner M.M.
        • McRae L.P.
        • Morrison F.D.
        Noninvasive detection and evaluation of carotid occlusive disease.
        Arch. Surg. 1973; 106: 528
        • Keitzer W.F.
        • Lichti E.L.
        • DeWeese M.S.
        Clinical evaluation and correction of carotid artery occlusive disease: Use of the Doppler ultrasonic flowmeter.
        Am. J. Surg. 1972; 124: 697
        • Kishore P.R.S.
        • Chase N.E.
        • Kircheff I.I.
        Carotid stenosis and intracranial emboli.
        Radiology. 1971; 100: 351
        • LoGerfo F.W.
        • Mason G.R.
        Directional Doppler studies of supraorbital artery flow in internal carotid stenosis and occlusion.
        Surgery. 1974; 76: 723
        • Machleder H.I.
        Evaluation of patients with cerebrovascular disease using the Doppler ophthalmic test.
        Angiology. 1973; 24: 374
        • Maroon J.C.
        • Campbell R.L.
        • Dyken M.L.
        Internal carotid artery occlusion diagnosed by Doppler ultrasound.
        Stroke. 1970; 1: 122
        • Moore W.S.
        • Hall A.D.
        Ulcerated atheroma of the carotid artery. A cause of transient cerebral ischemia.
        Am. J. Surg. 1968; 116: 237
        • Müller H.R.
        The diagnosis of internal carotid artery occlusion by directional Doppler sonography of the ophthalmic artery.
        Neurology. 1972; 22: 816
        • Russell H.E.
        • Burger R.J.
        • Barnes R.W.
        The Doppler ultrasonic cerebrovascular examination: Improved accuracy by refinement of technique.
        in: abstract presented at Twentieth Annual Conference. American Institute of Ultrasound in Medicine, Winston-Salem, N.COct., 1975
        • Seldinger S.L.
        Catheter replacement of the needle in percutaneous arteriography. A new technique.
        Acta Radiol. 1953; 39: 368
        • Thompson J.E.
        Surgery for cerebrovascular insufficiency (stroke) with special emphasis on carotid endarterectomy.
        Charles C Thomas, Publisher, Springfield, Ill1968
        • Wise G.
        • Brockenbrough E.C.
        • Marty R.
        • et al.
        The detection of carotid artery obstruction: A correlation with arteriography.
        Stroke. 1971; 2: 105
        • Wood E.H.
        Thermography in the diagnosis of cerebrovascular disease.
        Radiology. 1965; 85: 270
        • Wylie E.J.
        • Ehrenfeld W.A.
        Extracranial occlusive cerebrovascular disease: Diagnosis and management.
        in: W. B. Saunders Company, Philadelphia1970: 122