DIAGNOSIS OF TRAUMATIC CAROTID-ARTERY DISSECTION BY TRANSCRANIAL DOPPLER ULTRASOUND - CASE-REPORT AND REVIEW OF THE LITERATURE

The clinical course, transcranial Doppler ultrasound (TCD) findings, a nd angiographic outcome are reported for a patient with a traumatic ca rotid artery dissection. Transient asymmetrical decreased middle cereb ral artery blood flow velocities led to the suspicion of an internal c arotid artery (ICA) stenosis. Duplex scanning and angiography subseque ntly demonstrated an extracranial traumatic ICA dissection in combinat ion with a traumatic saccular aneurysm. These data imply that TCD moni toring has a potential to diagnose not only well established complicat ions of neurotrauma, such as vasospasm and intracranial hypertension, but may also suggest the presence of traumatic extracranial carotid ob structions.