Zurbruegg H. Evaluation of cerebrovascular disease by combined extracranial andpatients with internal carotid artery occlusion: correlation with cerebral angiography

Results from 1,039 combined cervical and transcranial Doppler examinations are reported. Satisfac-tory transcranial signals were not found in 2.7 % of the cases. Compared with angiography, the accuracy of transcranial criteria in assessing collateral flow over the circle of Willis was 94 and 88% for anterior and posterior circulation, respectively. The method also appeared very promising for detection of lesions of the intracranial arteries although the number of such cases with angiographic verification was limited in the present series. Arterial narrowing due to cerebral vasospasm was diagnosed with a sensitivity of 80%. In patients with ruptured intracranial aneurysms, an incidence of 93 % arterial narrowing in basal cerebral arteries was found. Patients with subarachnold hemorrhage and no aneurysm on angiography also showed arterial narrowing with an incidence of 56%. It was possible to monitor the time course and severity of cerebral vasospasm. Arteriovenous malformations were characterized by Doppler findings of high velocities and low pulsatilities. These lesions were diagnosed with an accuracy of 95%. (Stroke 1987;18:1018-1024) Noninvasive Doppler examination of the extra-cranial arteries was introduced in 1965 andhas become a routine procedure in clinical practice. Further extension of Doppler techniques to the intracranial circulation was difficult due to the re