case_images: PMC2822791_01
case_images: On patient presentation, the transcranial Doppler showed a dampened flow at the level of the basilar artery: a pulsatile flow with normal flow acceleration and decreased mean flow velocity (>30% difference between the proximal and distal arterial segments).
case_images: 1752-1947-4-13-1.jpg
case_images: PMC2822791_01_1752-1947-4-13-1.jpg
case_images: F1
case_images: A transcranial Doppler with suboccipital approach showed the typical pattern of 'dampened flow' (mean flow velocity 14.1 cm/sec; resistance index (RI) 0.62; pulsatility index (PI) 1.10) on the basilar artery at 75 mm depth (Figure 1).
case_images: Two hours later, the transcranial Doppler showed a stenotic flow at the level of the basilar artery: a focal mean flow velocity increase >30% compared with the proximal arterial segment.
case_images: 1752-1947-4-13-2.jpg
case_images: PMC2822791_01_1752-1947-4-13-2.jpg
case_images: F2
case_images: A control transcranial Doppler showed restored flow with a minor velocity increase at the level of the proximal basilar artery (mean flow velocity: 68.3 cm/sec), probably an expression of residual stenosis (Figure 2).
case_images: On the following day, the transcranial Doppler showed a normal flow at the level of the basilar artery: a low-resistance antegrade flow with mean flow velocity <60 cm/sec.
case_images: 1752-1947-4-13-3.jpg
case_images: PMC2822791_01_1752-1947-4-13-3.jpg
case_images: F3
case_images: Then a transcranial Doppler was performed and normal blood flow velocities were documented (Figure 3).