Colleen Douville, RVT
Harborview Medical Center
University of Washington
Seattle, WA

Patient History

GI is a 59 year old right-handed male with multiple risk factors for cerebrovascular disease including diabetes, hypercholestrolemia and a prior history of tobacco use. He is 15 years status post below knee amputation for peripheral vascular disease. He presents with complaints of one episode of left face and arm numbness of approximately five minutes duration.

Image Findings

Results and Discussions

Carotid Duplex Findings
Non-stenotic calcified posterior wall plaque of the left common carotid artery (CCA) with bilateral CCA intima-media thickening. 1-15% diameter reduction (non-stenotic wall plaque) of the bilateral internal carotid arteries (ICA). Left external carotid artery (ECA) > 50% diameter reduction/stenosis. The bilateral vertebral arteries are patent, antegrade and without abnormality. The bilateral subclavian arteries are normal.

Transcranial Imaging
Good visualization of the bilateral middle cerebral (MCA), anterior cerebral, cavernous internal, ophthalmic, posterior cerebral and vertebral arteries. The right vertebral artery is dominant. The basilar artery was examined from the confluence of the vertebral arteries to the distal tip. All flow velocities are normal and there is no evidence of intracranial arterial vascular pathology.

Photopic increased confidence in the degree and extent of minor plaque morphology and enhanced borders between plaque, vessel wall, and flow areas. The plaque outline is sharpened and background noise lessened, therefore outlining the plaque with better precision.

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