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CT angiography and Doppler sonography for emergency assessment in acute basilar artery ischemia

T Brandt1, M Knauth, S Wildermuth

  • 1Department of Neurology, University of Heidelberg, Germany. tobiasvbrandt@ukl.uni-heidelberg.de

Stroke
|March 6, 1999
PubMed

Insights

CT angiography (CTA) is superior to Doppler sonography (DS) for diagnosing basilar artery (BA) occlusion in acute cerebral ischemia. CTA offers better feasibility and conclusiveness, especially for distal occlusions, aiding treatment decisions.

Area of Science:

  • Neurology
  • Vascular Imaging
  • Medical Diagnostics

Background:

  • Acute basilar artery (BA) ischemia presents a diagnostic challenge.
  • Noninvasive vascular assessment tools like Doppler sonography (DS) and CT angiography (CTA) are crucial.
  • The diagnostic utility of CTA in acute BA ischemia remained unstudied.

Purpose of the Study:

  • To evaluate the diagnostic performance of CTA compared to DS for acute basilar artery occlusion.
  • To assess the feasibility and conclusiveness of CTA in identifying BA patency and occlusion.

Main Methods:

  • Prospective study of 19 patients with suspected acute BA occlusion.
  • Utilized both Doppler sonography (DS) and CT angiography (CTA) for vascular assessment.
  • Digital subtraction angiography (DSA) was performed in 6 patients for comparison.

Main Results:

  • CTA was diagnostic in 18 of 19 patients, accurately identifying BA occlusion (complete/incomplete) or patency.
  • DS was diagnostic in only 7 of 19 patients, with 9 inconclusive results and 2 false-negatives for distal occlusion.
  • CTA provided detailed information on occlusion site, length, and collateral pathways, guiding thrombolysis in 5 patients.

Conclusions:

  • CTA demonstrated superior feasibility and conclusiveness over DS for assessing BA patency in acute ischemia.
  • CTA is particularly advantageous for diagnosing distal BA occlusions.
  • Combined extracranial and transcranial DS remains useful for proximal BA occlusion diagnosis.
Abstract

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