Ultrasound of carotid and vertebral arteries in the emergency department

Abstract:

In patients with symptoms of stroke, transient ischemic attack or amaurosis fugax, it is necessary to assess when to proceed with emergency ultrasound imaging of the carotid arteries and how to take care of the patient in a timely manner if significant stenosis of the carotid artery or dissection of the blood vessels of the neck is proven. Ultrasound imaging of the carotid arteries can assess their morphology and hemodynamics, with special emphasis on the existence of atherosclerotic plaques and peak systolic velocity (PSV). After the diagnosis of significant stenosis of the carotid artery, medical and operative treatment is started. The intervention is most useful for patients with 70-99% stenosis, with maximum benefit if it is performed within two weeks of the ischemic event, which is why it is important that ultrasound diagnostics be performed in a relatively short time after the patient‘s arrival for examination in the emergency department.

Key words:
carotid artery stenosis; carotid ultrasound; stroke cervical arterial dissection; transient ischemic attack