EMBOLIC STROKE BY COMPRESSION MANEUVER DURING TRANSCRANIAL DOPPLER SONOGRAPHY

Background and Purpose Embolic complications during ultrasound examina tions are a rare cause of neurological deficits. The present case docu ments the occurrence of embolism by a nonobstructive compression maneu ver during transcranial Doppler examination, resulting in a minor stro ke. Case Description A 63-year-old man suffered from recurrent transie nt ischemic attacks. Duplex sonography showed a small echogenic plaque at the right carotid bifurcation. During transcranial Doppler studies with a reverberating compression maneuver of the right common carotid artery low in the neck, multiple emboli signals were detected, and th e patient developed a left-sided hemiparesis with slurred speech. Fund uscopy revealed cholesterol emboli in the inferior temporal arteriole of the right eye. These findings suggested embolization as the cause o f the stroke. Conclusions Compression maneuvers should not be performe d in patients with recent neurological symptoms, even in the case of o nly small lesions in the extracranial carotid territory.