Historical Steps in Establishing Diagnostic Criteria for Grading Stenosis of Brain Supplying Arteries: A Litmus Test for Clinical Usefulness

Abstract

This publication describes the development of the diagnosis of stenosing diseases of brain-supplying arteries using ultrasound Doppler sonography, based on the personal experience of the author. It starts with the search test of flow alteration at the ophthalmic arteries as evidence of upstream obstruction and ends with the examination of extra- and intracranial arteries using Color Duplex technology. The advantage of ultrasound diagnostics is the good morphological description of the wall changes together with the assessment of hemodynamics. A meaningful assessment of the degree of stenosis requires knowledge of existing collateral circulation. The clinical utility of this method is in constant flux, depending on new therapeutic methods.