Summary
Compression tests performed during transcranial Doppler sonography are intended for support in identifying vessels and measuring collateral circulation within the circle of Willis. The resulting information is thought to be valuable in patients with extracranial carotid stenoses, especially for planning carotid and extra-/intracranial bypass surgery. In a retrospective analysis of a series of 380 cases, two patients with symptomatic carotid artery stenoses suffered three compression-induced focal cerebral ischemias. In two instances, these ischemias started under compression. The resulting deficits were reversible. One patient developed an additional and persisting motor deficit whose onset was delayed. The diagnostic benefit of compression tests is not established nor its risk well defined. They should not be used routinely.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- CCA:
-
common carotid artery
- TCD:
-
transcranial Doppler sonography
- ICA:
-
internal carotid artery
- CCT:
-
cranial computed tomography
References
Aaslid R (1986) Transcranial Doppler examination techniques. In: Aaslid R (ed) Transcranial Doppler sonography. Springer, Vienna New York
Askey JM (1946) Hemiplegia following carotid sinus stimulation. Am Heart J 31:131–137
Bass A, Krupski WC, Dilley RB, Bernstein EF, Otis SM (1990) Comparison of transcranial and cervical continuous-wave Doppler in the evaluation of intracranial collateral circulation. Stroke 21:1584–1588
Calverley JR, Millikan CH (1961) Complications of carotid manipulation. Neurology 11:185–189
Cormier JM, Fermand M, Massoni JM (1987) Appreciation preoperatoire du risque de clampage dans la chirurgie carotidienne et adoptation de la technique operatoire. J Chir (Paris) 124:585–592
Fermand M, Melki JP, Chaunfour J, Riche MC, Cormier JM (1987) Evaluation des suppleances arterielles dans les stenoses carotidiennes par angiographie numerisee intraarterielle globale sus-sigmoidienne. Interet predictif en chirurgie carotidienne. J Belge Radiol 70:319–327
Harders A (1986) Neurosurgical applications of transcranial Doppler sonography. Springer, Vienna New York
Harrison MJG, Iansek R, Marshall J (1986) Clinical identification of TIAs due to carotid stenosis. Stroke 17:391–392
Keller HM (1990) Doppler-Sonographie (kontinuierliche Emission) bei extrakraniellen Arterienkrankheiten. In: Kriessmann A, Bollinger A, Keller HM (eds) Praxis der Doppler-Sonographie. Thieme, Stuttgart, pp 161–320
Mohr JP (1986) Clinical syndromes of middle cerebral artery territory infarction. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM (eds) Stroke, pathophysiology, diagnosis, and management. Churchill Livingstone, New York, pp 387–450
Mormor J, Sofirstein MR (1941) Bilateral thrombosis of anterior cerebral artery following stimulation of a hyperactive carotid sinus. JAMA 117:1089–1090
Nelson DA, Mahru MM (1963) Death following digital artery occlusion. Arch Neurol 8:640–643
Ringelstein EB (1989) A practical guide to transcranial Doppler sonography. In: Weinberger J (ed) Noninvasive imaging of cerebrovascular disease. Frontiers of Clinical Neuroscience. Liss, pp 75–121
Silverstein A, Doniger D, Bender MB (1960) Manual compression of the carotid vessels, carotid sinus hypersensitivity, and carotid artery occlusions. Ann Intern Med 52:172–181
Webster JE, Gurdjian FJ (1957) Observation upon response to digital carotid artery compression in hemiplegic or hemiparetic patients. Neurology 7:757–762
Zeman FD, Siegal S (1947) Monoplegia following carotid sinus pressure in the aged. Am J Med Sci 213:603–607
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mast, H., Ecker, S. & Marx, P. Cerebral ischemia induced by compression tests during transcranial Doppler sonography. Clin Investig 71, 46–48 (1993). https://doi.org/10.1007/BF00210963
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00210963