Doppler cerebrovascular examination: improved results with refinements in technique.

Doppler ultrasonic assessment of extracranial carotid occlusive disease has been modified to decrease the incidence of false positive and negative diagnoses. The technique, which assessed directional flow in the frontal artery and the influence of sequential compression of each temporal, infraorbital, facial and common carotid artery, was performed on 152 vessels visualized by contrast arteriography. Presence or absence of significant (greater than 50%) stenosis or occlusion of the internal carotid artery was identified correctly in 150 vessels (98.7%). Inasmuch as the classic temporal artery compression test only detected 39 of the 61 abnormal Doppler studies (64%), the more complete examination is recommended for screening patients for significant carotid artery obstruction.