Detection of asymptomatic cerebral embolic signals with Doppler ultrasound

Can asymptomatic cerebral emboli be detected? With transcranial Doppler ultrasonography of the middle cerebral artery, short-duration high-intensity asymptomatic embolic signals were detected in 6 of 25 patients with carotid stenosis and in 9 of 24 with prosthetic cardiac valves, but not in 20 normal controls. In carotid stenosis the signals were usually unilateral and ipsilateral to the stenosis. Embolic signals were significantly more common in patients with mechanical valves than with pig xenografts (8/13 vs 1/11). With mechanical valves embolic signals were usually bilateral. Detection of asymptomatic emboli may allow identification of and preventive treatment in at-risk patients.