What a carotid ultrasound shows
Two carotid arteries run up either side of the neck to the brain. Plaque builds where the artery divides, and a piece of that plaque — or a clot forming on it — can travel downstream and block a vessel in the brain. That is a stroke.
The study measures how fast blood moves through each segment. Blood speeds up through a narrowing, so the velocity tells us how tight it is. We also look at the plaque itself: how much there is, how it is built, and whether it has the features that make it unstable.
Why it matters
Most carotid disease causes no symptoms until it causes a stroke. That is the argument for looking. Carotid Artery Disease →
Who should have one
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Anyone with a transient ischemic attack or stroke — sudden weakness, numbness, slurred speech, or brief loss of vision in one eye
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A bruit — the sound of turbulent flow — heard in the neck on exam
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Known atherosclerosis elsewhere: coronary disease, or peripheral artery disease
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Surveillance of a known narrowing, or after a stent or endarterectomy
Population-wide screening of people with no symptoms and no risk factors is not recommended. Screening the right people is.
When to call 911
Stroke symptoms are an emergency and every minute of delay costs brain tissue.
Call 911 right away if you have any of these:
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Sudden weakness or numbness of the face, arm, or leg — especially on one side
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Sudden confusion, trouble speaking, or trouble understanding speech
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Sudden trouble seeing in one or both eyes, or a curtain coming down over one eye
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Sudden severe headache with no known cause, dizziness, or loss of balance
Call even if the signs last only briefly. Do not drive yourself, do not call our office first, and do not wait to see whether it passes.
For referring providers — Carotid duplex is performed in our office and read by the treating physician. Symptomatic patients are worked in the same day if possible. Refer: (918) 943-5303 · fax (855) 312-3594.
Refer urgently: any TIA or stroke symptom, amaurosis fugax, or a symptomatic stenosis · Routinely: a cervical bruit, known atherosclerosis elsewhere, or surveillance of a known stenosis. Full referral guide →