Color duplex Doppler ultrasonography of the brachiocephalic vessels (intracranial and extracranial)

Color duplex Doppler ultrasound of the brachiocephalic vessels (intracranial and extracranial) is a modern, non-invasive and painless imaging method that allows simultaneous assessment of vascular anatomy and blood flow characteristics.

The examination includes both extracranial vessels (carotid and vertebral arteries) and intracranial structures, including the arteries of the Circle of Willis and their branches. The method combines B-mode imaging (visualization of vessel walls), Doppler analysis (evaluation of flow velocity and direction), and color flow mapping.

The following structures are assessed:

• common, internal, and external carotid arteries supplying the brain and facial tissues;
• vertebral arteries forming the basilar artery and supplying the brainstem and cerebellum;
• vessels of the Circle of Willis, ensuring collateral cerebral circulation;
• venous vessels of the head and neck when indicated.

This method enables detection of stenosis, occlusions, dissections, atherosclerotic plaques, embolic risk, and functional disturbances of cerebral circulation. It plays a key role in early diagnosis and stroke prevention.

Indications

• Headaches, dizziness, tinnitus;
• Visual, speech, or coordination disturbances;
• Syncope or presyncope episodes;
• Suspected cerebrovascular insufficiency;
• Arterial hypertension, diabetes mellitus, atherosclerosis;
• History of stroke or transient ischemic attack;
• Cervical spine disorders;
• Vascular risk assessment (including smokers);
• Preoperative evaluation and postoperative monitoring;
• Follow-up of chronic vascular conditions.

Procedure / Duration

• The patient lies in a supine position;
• Ultrasound gel is applied to the neck and, if needed, temporal areas;
• The physician examines the vessels using an ultrasound probe;
• Blood flow velocity, direction, and symmetry are assessed;
• The procedure is painless and non-invasive;
• Duration: approximately 20–30 minutes;
• Results are usually available immediately after the examination.

Contraindications

• No absolute contraindications;
• Relative: skin lesions or inflammatory conditions in the examination area.

Recovery / Restrictions

• No recovery period required;
• Patients can resume normal activities immediately;
• No post-procedure restrictions.

Advantages

• Safe and non-invasive;
• No radiation exposure;
• Combined structural and functional assessment;
• Early detection of vascular abnormalities;
• Suitable for repeated follow-up;
• Fast and accessible results.

Sources:

https://radiopaedia.org/articles/transcranial-doppler-sonography-ultrasound-1
https://medlineplus.gov/ency/article/007759.htm
https://pmc.ncbi.nlm.nih.gov/articles/PMC5224659/  
https://pmc.ncbi.nlm.nih.gov/articles/PMC3846948/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3902805/