Ultrasound Int Open 2015; 01(02): E53-E57
DOI: 10.1055/s-0035-1565130
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

The Posterior Cerebral Artery and its Main Cortical Branches Identified with Noninvasive Transcranial Color-Coded Duplex Sonography

P. E. Frid
1   Department of Neurology, Institute for Clinical Sciences, Malmö, Sweden
,
S. J. Schreiber
2   Neurology, Charité Berlin, Berlin, Germany
,
O. Pade
3   Department of Neurology and Neurophysiology, AMEOS Klinikum Neustadt, Neustadt i. H., Germany
,
F. Doepp
4   Department of Neurology, Charité Campus Virchow, Berlin, Germany
,
J. Valdueza
5   Neurologie, Neurologisches Zentrum der Segeberger Kliniken, Bad Segeberg, Germany
› Author Affiliations
Further Information

Publication History

received 24 June 2015

accepted 12 October 2015

Publication Date:
06 November 2015 (online)

Abstract

Purpose: To differentiate PCA segments and cortical branches by means of transcranial color-coded duplex sonography (TCCD) and to measure flow parameters at rest and during visual stimulation.

Materials and Methods: 60 healthy subjects with a good acoustic temporal bone window were examined. The main stem of the PCA (P1, P2 and P3) and 4 main cortical branches – the anterior temporal artery (ATA), the occipital temporal artery (OTA), the parietooccipital artery (POA) and the calcarine artery (CA) – were assessed using an axial transtemporal approach. Systolic and diastolic blood flow velocities (BFVs) were recorded at rest and during visual stimulation.

Results: Identification of the P1 segment of the PCA was successful in 97.5% (117/120) of cases. The P2 and P3 segments were visualized in all cases. The 4 main cortical branches could be identified to varying degrees: ATA in 88%, OTA in 96%, POA in 69% and CA in 62%. There was an evoked flow response in the P2 main stem and in all cortical branches. The most pronounced increase in diastolic/systolic BFV after visual stimulation test was seen in the CA (42%/35%), followed by P2 (30%/24%), the POA (27%/27%), the OTA (16%/13%) and the ATA (9%/8%).

Conclusion: Insonation through the temporal bone window with TCCD confidently allows the assessment of the P1 to P3 segments of the PCA as well as the 2 proximal branches, the ATA and the OTA. An ultrasound-based classification of PCA anatomy and its cortical branches may be used as a noninvasive method for the evaluation of posterior circulation pathology.

 
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