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Radiology · Head and neck imaging: carotid Doppler
Sample itemA patient with transient monocular blindness has carotid Doppler showing a high peak systolic velocity at the origin of the internal carotid artery. What does it indicate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Significant carotid stenosis
Elevated peak systolic velocity (above about 125 cm/s for moderate and above 230 cm/s for severe stenosis) and post-stenotic turbulence show haemodynamically significant ICA stenosis. Amaurosis fugax is an embolic phenomenon from carotid plaque. Symptomatic stenosis over 70 percent warrants endarterectomy.
Option by option
A. Vertebral artery dissection
Vertebral dissection involves the posterior circulation.
B. Significant carotid stenosis (correct)
Correct. High velocity at the stenosis suggests a significant narrowing.
C. Normal flow
Normal flow would not produce a high PSV.
D. Subclavian steal
Subclavian steal shows reversed vertebral flow.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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