An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease

J. L. Wilterdink, E. Feldmann, M. Bragoni, J. M. Brooks, J. G. Benavides

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Transcranial Doppler ultrasound provides a useful adjunct to extracranial ultrasound in the diagnosis of carotid bifurcation disease. Previous studies have shown that collateral flow patterns and diminished flow velocities in the ipsilateral middle cerebral artery correlate with hemodynamically significant carotid disease. In a series of 7,054 carotid duplex and transcranial Doppler examinations, 12 5% (95% confidence interval [CI]: 8.7, 16.4) of 287 ophthalmic arteries ipsilateral to an apparent carotid occlusion had no detectable flow signal, compared with 0.5% (95% CI: 0.3, 0.7) of 6,767 ophthalmic arteries ipsilateral to a nonoccluded carotid artery (p <0.001). Carotid siphon signals were not detectable in 24.4% (95% CI: 19.4, 29.4) of arteries ipsilateral to the carotid occlusion, versus 1.0% (95% CI: 0.8, 1.3) ipsilateral to nonoccluded carotid arteries (p <0.001). A significant number of absent ophthalmic artery and carotid siphon signals (5.7 and 8.7%, respectively) were also found in patients with 80 to 99% extracranial carotid stenosis. A subset of 216 studies with angiographic correlation confirmed the high association of these transcranial Doppler findings with severe stenosis or occlusion of the internal carotid artery. Primary ophthalmological disease or siphon occlusion did not explain these findings. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler examination is believed to represent a failure to detect slow flow distal to severe carotid bifurcation lesions. As a sign of ipsilateral carotid occlusion, the sensitivities of absent ophthalmic artery and carotid siphon signals are quite low (12.5 and 24.4%, respectively). The high specificities of 99.5 and 99.0%, however, make these findings useful in confirming the diagnosis of presumptive carotid occlusion by carotid duplex ultrasound.

Original languageEnglish
Pages (from-to)196-199
Number of pages4
JournalJournal of Neuroimaging
Volume4
Issue number4
Publication statusPublished - 1994

Fingerprint

Ophthalmic Artery
Carotid Artery Diseases
Confidence Intervals
Carotid Arteries
Doppler Ultrasonography
Carotid Stenosis
Middle Cerebral Artery
Internal Carotid Artery
Pathologic Constriction
Arteries

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neuroscience(all)
  • Radiological and Ultrasound Technology

Cite this

An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease. / Wilterdink, J. L.; Feldmann, E.; Bragoni, M.; Brooks, J. M.; Benavides, J. G.

In: Journal of Neuroimaging, Vol. 4, No. 4, 1994, p. 196-199.

Research output: Contribution to journalArticle

Wilterdink, J. L. ; Feldmann, E. ; Bragoni, M. ; Brooks, J. M. ; Benavides, J. G. / An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease. In: Journal of Neuroimaging. 1994 ; Vol. 4, No. 4. pp. 196-199.
@article{d76fa7a13fe74d9298e3d4de4a6b8529,
title = "An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease",
abstract = "Transcranial Doppler ultrasound provides a useful adjunct to extracranial ultrasound in the diagnosis of carotid bifurcation disease. Previous studies have shown that collateral flow patterns and diminished flow velocities in the ipsilateral middle cerebral artery correlate with hemodynamically significant carotid disease. In a series of 7,054 carotid duplex and transcranial Doppler examinations, 12 5{\%} (95{\%} confidence interval [CI]: 8.7, 16.4) of 287 ophthalmic arteries ipsilateral to an apparent carotid occlusion had no detectable flow signal, compared with 0.5{\%} (95{\%} CI: 0.3, 0.7) of 6,767 ophthalmic arteries ipsilateral to a nonoccluded carotid artery (p <0.001). Carotid siphon signals were not detectable in 24.4{\%} (95{\%} CI: 19.4, 29.4) of arteries ipsilateral to the carotid occlusion, versus 1.0{\%} (95{\%} CI: 0.8, 1.3) ipsilateral to nonoccluded carotid arteries (p <0.001). A significant number of absent ophthalmic artery and carotid siphon signals (5.7 and 8.7{\%}, respectively) were also found in patients with 80 to 99{\%} extracranial carotid stenosis. A subset of 216 studies with angiographic correlation confirmed the high association of these transcranial Doppler findings with severe stenosis or occlusion of the internal carotid artery. Primary ophthalmological disease or siphon occlusion did not explain these findings. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler examination is believed to represent a failure to detect slow flow distal to severe carotid bifurcation lesions. As a sign of ipsilateral carotid occlusion, the sensitivities of absent ophthalmic artery and carotid siphon signals are quite low (12.5 and 24.4{\%}, respectively). The high specificities of 99.5 and 99.0{\%}, however, make these findings useful in confirming the diagnosis of presumptive carotid occlusion by carotid duplex ultrasound.",
author = "Wilterdink, {J. L.} and E. Feldmann and M. Bragoni and Brooks, {J. M.} and Benavides, {J. G.}",
year = "1994",
language = "English",
volume = "4",
pages = "196--199",
journal = "Journal of Neuroimaging",
issn = "1051-2284",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - An absent ophthalmic artery or carotid siphon signal on transcranial Doppler confirms the presence of severe ipsilateral internal carotid artery disease

AU - Wilterdink, J. L.

AU - Feldmann, E.

AU - Bragoni, M.

AU - Brooks, J. M.

AU - Benavides, J. G.

PY - 1994

Y1 - 1994

N2 - Transcranial Doppler ultrasound provides a useful adjunct to extracranial ultrasound in the diagnosis of carotid bifurcation disease. Previous studies have shown that collateral flow patterns and diminished flow velocities in the ipsilateral middle cerebral artery correlate with hemodynamically significant carotid disease. In a series of 7,054 carotid duplex and transcranial Doppler examinations, 12 5% (95% confidence interval [CI]: 8.7, 16.4) of 287 ophthalmic arteries ipsilateral to an apparent carotid occlusion had no detectable flow signal, compared with 0.5% (95% CI: 0.3, 0.7) of 6,767 ophthalmic arteries ipsilateral to a nonoccluded carotid artery (p <0.001). Carotid siphon signals were not detectable in 24.4% (95% CI: 19.4, 29.4) of arteries ipsilateral to the carotid occlusion, versus 1.0% (95% CI: 0.8, 1.3) ipsilateral to nonoccluded carotid arteries (p <0.001). A significant number of absent ophthalmic artery and carotid siphon signals (5.7 and 8.7%, respectively) were also found in patients with 80 to 99% extracranial carotid stenosis. A subset of 216 studies with angiographic correlation confirmed the high association of these transcranial Doppler findings with severe stenosis or occlusion of the internal carotid artery. Primary ophthalmological disease or siphon occlusion did not explain these findings. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler examination is believed to represent a failure to detect slow flow distal to severe carotid bifurcation lesions. As a sign of ipsilateral carotid occlusion, the sensitivities of absent ophthalmic artery and carotid siphon signals are quite low (12.5 and 24.4%, respectively). The high specificities of 99.5 and 99.0%, however, make these findings useful in confirming the diagnosis of presumptive carotid occlusion by carotid duplex ultrasound.

AB - Transcranial Doppler ultrasound provides a useful adjunct to extracranial ultrasound in the diagnosis of carotid bifurcation disease. Previous studies have shown that collateral flow patterns and diminished flow velocities in the ipsilateral middle cerebral artery correlate with hemodynamically significant carotid disease. In a series of 7,054 carotid duplex and transcranial Doppler examinations, 12 5% (95% confidence interval [CI]: 8.7, 16.4) of 287 ophthalmic arteries ipsilateral to an apparent carotid occlusion had no detectable flow signal, compared with 0.5% (95% CI: 0.3, 0.7) of 6,767 ophthalmic arteries ipsilateral to a nonoccluded carotid artery (p <0.001). Carotid siphon signals were not detectable in 24.4% (95% CI: 19.4, 29.4) of arteries ipsilateral to the carotid occlusion, versus 1.0% (95% CI: 0.8, 1.3) ipsilateral to nonoccluded carotid arteries (p <0.001). A significant number of absent ophthalmic artery and carotid siphon signals (5.7 and 8.7%, respectively) were also found in patients with 80 to 99% extracranial carotid stenosis. A subset of 216 studies with angiographic correlation confirmed the high association of these transcranial Doppler findings with severe stenosis or occlusion of the internal carotid artery. Primary ophthalmological disease or siphon occlusion did not explain these findings. An absent ophthalmic artery or carotid siphon signal on transcranial Doppler examination is believed to represent a failure to detect slow flow distal to severe carotid bifurcation lesions. As a sign of ipsilateral carotid occlusion, the sensitivities of absent ophthalmic artery and carotid siphon signals are quite low (12.5 and 24.4%, respectively). The high specificities of 99.5 and 99.0%, however, make these findings useful in confirming the diagnosis of presumptive carotid occlusion by carotid duplex ultrasound.

UR - http://www.scopus.com/inward/record.url?scp=0028043442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028043442&partnerID=8YFLogxK

M3 - Article

VL - 4

SP - 196

EP - 199

JO - Journal of Neuroimaging

JF - Journal of Neuroimaging

SN - 1051-2284

IS - 4

ER -