High-Grade Stenosis of a Traumatic Brachiocephalic Pseudoaneurysm and the Change in Cerebral Blood Flow Assessed With Transcranial Doppler Ultrasound. Issue 2 (June 2021)

• Record Type: Journal Article
• Authors: Nguyen, Winnie; Albanese, Tammy; Tran, Vanessa; Moore, Anne; Sekhar, Laligam
• Is Part Of: Journal for vascular ultrasound. Volume 45:Issue 2(2021)
• Page Start: 71
• Page End: 75
• Publication Date: 2021-06
• Subjects: transcranial Doppler -- cerebrovascular accident -- emboli -- pseudoaneurysm -- Doppler ultrasound -- stroke; Cardiovascular system -- Diseases -- Diagnosis -- Periodicals; Cardiovascular system -- Diseases -- Ultrasonic imaging -- Periodicals; Electronic journals; Periodicals; 616.1307543
• DOI: 10.1177/15443167211002315
• Languages: English
• ISSNs: 1544-3167

Abstract

This is a case report of a 35-year-old female pedestrian struck by a semi-truck. computed tomographic angiography (CTA) revealed a pseudoaneurysm at the proximal brachiocephalic artery measuring 1.8 cm in cranio-caudal length and 1.2 × 0.6 cm transverse. Just distal to the pseudoaneurysm, there was severe luminal narrowing caused by either a dissection flap or mural thrombus. Due to profound left-sided weakness, transcranial Doppler ultrasound was performed which demonstrated "hesitant" waveforms in the right middle cerebral and right vertebral arteries secondary to proximal obstruction. Hesitant waveforms display mid-systolic velocity deceleration and may also be referred to as the "bunny" waveform. Emboli monitoring of the right middle cerebral and basilar arteries were positive for active embolization