TCD can therefore be used as an adjunctive tool to manage patients with suspected carotid dissection and may prove useful in evaluating the efficacy of treatment in reducing microemboli and subsequent stroke. Adequate documentation is essential for high-quality patient care and to demonstrate the reasonableness and medical necessity of the study (ies). We have demonstrated a high incidence of intracranial microemboli in the MCA distal to carotid dissections and a significant correlation between the presence of emboli and stroke. The billing and coding information in this article is dependent on the coverage indications, limitations and/or medical necessity described in the related LCD. CPT Code:, Electrocardiogram with 15 leads including the interpretation and report. The presence of a pseudoaneurysm did not increase the risk of either microemboli or stroke. Study with Quizlet and memorize flashcards containing terms like Transcranial Doppler study of the intracranial arteries, limited study. Patients with microemboli detected by TCD presented with a stroke (70%) much more frequently than those without emboli (14%) (P=.0498). Emboli monitoring was performed in the middle cerebral artery (MCA) ipsilateral to the dissection at the initial evaluation and intermittently thereafter to ensure that the emboli stopped with treatment.Įmboli were detected in the MCA distal to the dissection in 10 of 17 patients (59%). Ten patients with ICA dissection secondary to trauma and seven with spontaneous ICA dissection were diagnosed by carotid angiography and studied by TCD from the time of diagnosis through initiation of therapy. ![]() Because the majority of these ischemic events are secondary to embolic phenomena, we used transcranial Doppler (TCD) evaluation with emboli monitoring to study 17 consecutive patients with ICA dissection treated at Harborview Medical Center, Seattle, Wash, during a 2-year period from 1992 until 1994. Thus far, it has not been possible to identify the subset of patients at risk for cerebral ischemia. A subject with dissection of the internal carotid artery (ICA) may present with a variety of symptoms, from headache to stroke.
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