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Stroke, Vol 16, 848-855, Copyright © 1985 by American Heart Association

ARTICLES

Non-invasive diagnosis of intracranial lesions in the vertebrobasilar system. A comparison of Doppler sonographic and angiographic findings

EB Ringelstein, H Zeumer and K Poeck

The accuracy and the reliability of extracranial vertebral Doppler flow (continuous wave Doppler sonography) for the detection of intracranial vertebrobasilar lesions was studied prospectively in twenty-one patients with brainstem disturbances and/or coma. The Doppler findings were compared with cerebral angiography. Doppler sonography was highly reliable for both detection and exclusion of high grade intracranial vertebrobasilar lesions. The pathognomonic Doppler finding was an abrupt deceleration of the blood column during systole and stoppage or even reflux during diastole. The same blood flow alterations were found in two additional illustrative cases having therapeutically or brain- death induced blockages of the vertebral arteries. The pathophysiologic mechanisms of flow disturbances and the limitations of Doppler sonography in this area are discussed.

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