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July2005 Vol.42 Issue:        2        Table of Contents
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Color Doppler Sonographic Changes of the Vertebral Arteries in Patients with Vertebrobasilar Transient Ischemic Attacks

Ahmed Osama1, M. Refaat Habba2, M. El-Beblawy2
Departments of Neurology1, Radiology2,Suez Canal University

ABSTRACT

 

Objective: To assess the Color Doppler Sonographic changes of the vertebral arteries in-patients with Vertebrobasilar transient ischemic attacks and to evaluate its possible role in those patients. Subjects And Methods: Color Doppler Sonography of the vertebral arteries has been made for 53 patients (106 vertebral arteries) with vertebrobasilar transient ischemic attacks and 53 sex- and age-matched controls. Results: The vertebral artery origin was the difficult segment to visualize among both patients and control subjects.  The left vertebral artery origin (55-60%) was especially more difficult to visualize than the right (75-79%). All the pretransverse and intertransverse segments were visualized on both sides in both groups (100%). The mean left vertebral artery diameter was slightly larger than the right in both groups. Real-time B-mode sonography detected atheromatous plaques in only 4 vertebral arteries in the patients (4%) and in only 1 (1%) in the control group. Color flow mapping detected no flow in two vertebral arteries (2%) in the patients.  Abnormal Doppler spectral wave patterns were found in 51% in patients and in 10% of control. The abnormal wave patterns of the patients were: high velocity flow pattern (35%), spectral broadening (11%) and tardus parvus (5%). Abnormal peak systolic velocities were found in 62% of patients and in 8% of control. The abnormal peak systolic velocities of the patients were high peak systolic velocity (53%) and low peak systolic velocity (9%). The most common site of abnormal Doppler changes was at the vertebral artery origin (41%) followed by the pretransverse segment (31%) and cervical segment (5%). There was a strong positive correlation between peak systolic velocity and Resistive Index and Pulsitility Index. Conclusion: Color Doppler Sonography is a valuable non-invasive diagnostic tool in-patient with vertebrobasilar ischemic diseases. It can provide the physician with a tool for the diagnosis, serial evaluation and follow up. It can also select patients for more invasive diagnostic and therapeutic angiographic procedures. However, its main limitation is the high incidence of non-visualization of vertebral artery origin.

(Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(2): 365-375).

 





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