Cervical Ultrasonography for Emergency Assessment in Acute Brainstem Infarction

Twenty-one patients (mean age •} SD, 67 •} 10 years) with acute brainstem infarction who were admitted to the emergency ward were studied. The flow velocity of the vertebral arteries was measured by cervical ultrasonography 24 h after onset of infarction. Fourteen patients underwent intra-arterial digital subtraction angiography within 20 h of cervical ultrasonography. Two of four patients with basilar artery occlusion showed bilateral absence of end-diastolic vertebral flow. The other two patients with basilar artery occlusion showed absence of end-diastolic flow on one side, and a mean velocity < 18 cm/s on the other. Two of three patients with basilar artery stenosis showed a mean velocity < 18 cm/s on either side of the vertebral artery. Measurement of vertebral artery flow velocity appeared to be valuable in the emergency assessment of acute brainstem infarction.