Forward Doppler ophthalmic artery flow in patients with extracranial carotid artery occlusion--a case report

The authors report 2 cases of common carotid artery (CCA) occlusion and 4 cases of extracranial internal carotid artery (ICA) occlusion with forward Doppler ophthalmic artery flow. The compression test during Doppler study showed that the ophthalmic artery flow was reduced to zero when compressed contralateral to the CCA in 1 case of CCA occlusion and when compressed ipsilateral to the CCA in all 4 cases of ICA occlusion. The angiograms showed that in the 2 cases of CCA occlusion, 1 had the ophthalmic artery originating from the anterior communicating artery, and the other had subclavian steal syndrome with a reversed vertebral flow. In 3 of the 4 cases of ICA occlusion, the ophthalmic artery was found to originate from the ipsilateral middle meningeal artery. Their findings suggest that in cases of extracranial carotid artery occlusion, the forward ophthalmic artery flow is supplied from the contralateral CCA in cases of CCA occlusion and from the branches of the ipsilateral external carotid artery in cases of ICA occlusion, and the vertebrobasilar system plays a less important role.