Transcranial Doppler

Question 1

What MHz transducer is used for TCD’s

Answer 1

2 MHz PW

Question 2

What must the angle be for TCD’s

Answer 2

0

Question 3

Why must you use PW for TCD’s

Answer 3

range resolution (depth or location)

Question 4

Name the 4 windows used for TCD’s

Answer 4

1) transorbital
2) Transtemporal
3) Transforamenal
4) Submandibular

Question 5

What is another name for transforamenal

Answer 5

suboccipital

Question 6

What vessels use a transtemporal window

Answer 6

1) ACA
2)MCA
3) Terminal ICA
4) PCA

Question 7

What is the depth for the ACA

Answer 7

60-80

Question 8

What direction does the ACA go

Answer 8

Retrograde (away)

Question 9

What is the depth for the MCA

Answer 9

30-60

Question 10

What direction does the MCA go

Answer 10

Antegrade (towards)

Question 11

What is the depth for the terminal ICA

Answer 11

55-65

Question 12

What direction does the terminal ICA go

Answer 12

Bidirectional

Question 13

What depth is used for the PCA

Answer 13

60-70

Question 14

What direction does the PCA go

Answer 14

Antegrade (towards)

Question 15

What vessels use a transorbital approach

Answer 15

1) opthalamic
2) ICA syphon

Question 16

What is the depth for the opthalamic

Answer 16

40-60

Question 17

What direction does the opthalamic go

Answer 17

Antegrade (towards)

Question 18

What vessel depth is used for the ICA syphon

Answer 18

60-80

Question 19

What direction does the ICA syphon go

Answer 19

Bidirectional

Question 20

What vessels use a transforamenal window

Answer 20

1) basilar
2) vertebral

Question 21

What vessel depth is used for the basilar

Answer 21

70-120

Question 22

What direction does the basilar go

Answer 22

Retrograde (away)

Question 23

What vessel depth is used for the vertebral

Answer 23

60-90

Question 24

What direction does the vertebral go

Answer 24

Retrograde (away)

Question 25

For cross over the contralateral ICA to ACA to ipsilateral ACA is through which artery

Answer 25

anterior communicating artery

Question 26

what is the normal flow direction of the basilar artery a) away from the probe b) bidirectional c) towards the probe d) positive doppler shift

Answer 26

a) away from the probe

Question 27

What is an indication of vasospasm due to cerebral hemorrhage a) EDV>140cm/s in the ICA b) turbulent flow in communicating vessels c) PSV>120cm/s in MCA d) tardus parvus in ACA

Answer 27

c) PSV > 120cm/s in MCA

Question 28

What is the best explanation for duplex findings which consist of high resistance flow patterns in the ICA and low resistance patterns in the ipsilateral ECA a) posterior to anterior collaterization b) collateralization via anterior communicating artery c) collateralization via the external branches of the opthalamic artery d) normal doppler patterns

Answer 28

c) collateralization via external branches of the opthalamic artery

Question 29

What is the normal flow direction of the MCA at the transtemporal window a) bidirectional b) antegrade c) retrograde d) variable

Answer 29

b) antegrade

Question 30

Which of the following scenarios could cause a low resistance pattern in the ECA a) posterior to anterior collateralization b) external to internal collateralization c) subclavian steal d) cross-over collateralization

Answer 30

b) external to internal collateralization

Question 31

When scanning through the transorbital window to evaluate the opthalamic artery, what should normal flow be a) below the baseline b) bidirectional c) retrograde d) antegrade

Answer 31

d) antegrade

Question 32

Upon TCD, a bidirectional signal is obtained at 57 mm depth from the temporal window. Which finding corresponds to what is being documented a) anterior cerebral and anterior communicating artery flow b) arteriovenous fistula c) middle cerebral and anterior cerebral artery flow d) mirror image artifact

Answer 32

c) middle cerebral and anterior cerebral artery flow

Question 33

Which intracranial vessel has retrograde flow scanning from the temple a) MCA b) ACA c) ICA d) PCA

Answer 33

b) ACA

Question 34

During TCD, what diagnostic finding would be consistent with left to right hemisphere collateralization a) flow towards the transducer in the right MCA b) flow towards the transducer in the left ACA c) flow in the transducer in the right ACA d) bidirectional flow in the left ICA bifurcation

Answer 34

c) flow towards the transducer in the right ACA

Question 35

A right handed patient presents with expressive aphasia and left paresis. Obstruction of which of the following vessels is most likely responsible for these symtpoms a) left ICA b) left vertebral c) basilar d) right ICA

Answer 35

d) right ICA - in a right handed person the left hemisphere is dominant for speech. A lesion in the left MCA would cause dysphasia or aphasia

Question 36

In TCD, with the probe placed over the right temporal bone, flow in the right ACA will be a) oriented away from the probe b) oriented toward the probe c) oriented at 90 to the probe d) the right MCA cannnot be seen from this window

Answer 36

a) oriented away from the probe

Question 37

In TCD, with the probe placed in the foramen magnum window, flow toward the probe in the vertebral artery is indicative of a) normalcy b) subclavian steal c) basilar artery stenosis d) ICA stenosis

Answer 37

b) subclavian steal

Question 38

A TIA of left amaurosis fugax is caused by a blockage in what vessel a) Right ICA b) Left ICA c) Left ECA d) Left CCA

Answer 38

b) Left ICA -Left eye= Left ICA amaurosis fugax always goes with the same side ICA

Question 39

The blood flow velocity parameter commonly reported in transcranial doppler is: a) peak systolic velocity b) flow volume c) time-averaged peak velocity d) time-averaged mean velocity

Answer 39

c) time-averaged peak velocity

Question 39

TCD findings of vasospasm in subarachnoid hemorrhage are a) absent flow in the MCA b) reversal of flow in the MCA c) bi-directional flow in the MCA d) greatly increased mean velocities in the MCA

Answer 39

d) greatly increased mean velocities in the MCA

Question 40

Which of the following is TCD not indicated for? a) vasospasm b) sickle cell disease c) temporal arteritis d) ophthalmic artery occlusion

Answer 40

c) temporal arteritis