Diagnostics & Testing

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Our state-of-the-art facility is equipped with the diagnostic tools needed to quickly assess cerebrovascular conditions, including:

Neurovascular Ultrasound Laboratory

Cleveland Clinic’s Neurovascular Ultrasound Laboratory in the Imaging Institute performs advanced, unique diagnostic examinations to detect abnormalities in the circulation of blood through the brain. Our lab, which performed more than 3,000 exams in 2008, has a national and international reputation for excellence in developing and applying the newest technology in neurovascular ultrasound for clinical research purposes. All our examinations are reviewed by board-certified neurologists or neuroradiologists and are performed by registered neurovascular sonographers.

Most imaging modalities can tell physicians if the blood vessels in the neck and brain are open. However, the exams performed in our Neurovascular Ultrasound Laboratory can also tell physicians how fast the blood is moving within these vessels. The velocity of the blood flow is important in assessing why a patient suffered a stroke or TIA and in determining the success of interventions after stenting and angioplasty.

What examinations are offered in the Neurovascular Ultrasound Laboratory?

The Neurovascular Ultrasound Laboratory offers a variety of non-invasive, cost effective tests for the assessment of cerebrovascular disease through the use of state-of-the-art equipment and technology. For the majority of these tests, no patient preparation is required, and testing usually takes less than one hour. Appointments are required.

Carotid Duplex Ultrasound

Carotid duplex ultrasound uses imaging technology to look for blood clots, plaque build-up and other blood flow problems in the carotid arteries. Our physicians use this technology to expertly diagnosis vessel stenosis (or narrowing of the vessels), occlusion, dissection, fibromuscular dysplasia, aneurysm, carotid body tumors and subclavian steal syndrome. Indications for use of carotid duplex ultrasound include transient ischemic attacks (TIA), stroke and Vertebrobasilar insufficiency.

Cerebrovascular Center
Transcranial Doppler Examination

Transcranial Doppler (TCD) is used to evaluate the blood flow through the blood vessels in the brain. An ultrasound transducer is placed over the temporal bones on the side of the skull, the foramen magnum in the back of the skull and over the closed eye lid. A reading of the blood flow is obtained from the vessels at the base of the brain (Circle of Willis).

The TCD exam is primarily used for the detection of intracranial stenosis (the narrowing of the vessels), thrombosis, occlusion or dissection. It is also used for the detection of vasospasm, the narrowing of the blood vessels in the brain that occurs following a subarachnoid hemorrhage. Indications for the TCD examination include transient ischemic attacks (TIA), stroke and vertebrobasilar insufficiency.

Transcranial Doppler Emboli Monitoring

Emboli are small pieces of plaque or “clots” that can form in the heart or break off plaque within blood vessels. Emboli passing through the blood stream can block a vessel in the brain and can be the cause of a TIA or stroke.

Transcranial Doppler Emboli Monitoring can detect any object that is not a red blood cell that passes our ultrasound beam. A vessel will be monitored for 30 minutes. The detection of emboli can provide a better understanding of what is causing a stroke, help direct therapeutic management and identify the patients who are at an increased risk of having a stroke.

Additional testing offered in the Neurovascular Ultrasound Laboratory includes:
  • Transcranial Doppler Imaging (TCI)
  • Transcranial Doppler Bubble Testing (TCB) for the detection of a hole between the chambers of the heart and patent foramen ovale
  • Transcranial Doppler of the posterior circulation (TCP), which evaluates the bilateral subclavian arteries, extracranial and intracranial vertebral arteries and basilar artery within the posterior aspect of the brain. Indications include syncope (passing out), dizziness and blurred vision.
  • Intraoperative monitoring of intracranial blood flow
  • Transcranial Doppler in sickle cell disease

Cleveland Clinic’s Neurovascular Laboratory welcomes referrals from outside physicians. For an appointment, call the radiology call center at 216.738.5460 or toll-free at 866.320.4573.

For more information, please contact Larry Raber, RDMS, RVT, RT(R), clinical manager of the Neurovascular Ultrasound Laboratory at 216.444.9129.

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