Choice of ophthalmic artery branch for Doppler cerebrovascular examination: advantages of the frontal artery.

One hundred normal young adult volunteers were assessed by directional Doppler ultrasound to determine which branch of the ophthalmic artery was most suitable for assessment of the patency of the extracranial internal carotid artery. Each frontal artery of all subjects had normal flow direction and response to compression of the temporal, facial, and common carotid arteries. One supraorbital artery of 2 subjects had reversed flow supplied by the ipsilateral temporal artery and was probably a palpebral artery in each of these individuals. The nasal artery carried reversed flow in 39% of the individuals and was undetectable unilaterally in 2 subjects. From these data we conclude that the frontal artery is the most suitable branch of the ophthalmic artery for Doppler ultrasonic examination. Evaluation of directional flow in the frontal artery and of the influence of compression of all branches of the external carotid artery as well as the common carotid artery is a highly reliable technique to identify significant obstruction of the extracranial internal carotid artery.