Serial transcranial Doppler monitoring after transient ischemic attack

The natural course of ultrasonically detectable microembolism in patients with a symptomatic extracranial atherosclerotic lesion is not completely understood. Furthermore, the potential impact of therapeutic management on microemboli detection is anecdotal. A 58-year-old man who experienced a left-hemisphere transient ischemic attack presented with an extracranial ipsilateral high-grade carotid stenosis. He was studied 12 times in 12 months during different medical management, during which time he was symptom free, even though transcranial Doppler evidence of microemboli continued for 5 months.