Carotid Doppler scans are one of the tools that your doctor can use to assess your stroke risk or to work out the best course of treatment for a stroke or transient ischemic attack (TIA). What exactly is a Doppler scan and how does it help us to understand your condition?

What is a Carotid Doppler Scan?

The carotid Doppler scan is a special type of ultrasound scan that can measure the blood flow through the arteries that supply your brain. The scan uses sound waves that are above the human range of hearing to create pictures of your insides. This kind of scan is focused on the carotid arteries in your neck. It will look for any restrictions on the movement of blood through the arteries.

Carotid Doppler scans are performed in a very similar way to other ultrasound scans. You will be asked to lie down and remove any clothing from around your neck. A lubricating gel will be applied to your skin and then the sonographer or doctor will pass the handheld ultrasound probe across your neck. You’ll feel some pressure from the probe as pictures are taken from different angles, but the Doppler scan is painless and completely safe.

The Carotid Arteries and Stroke Risk

The carotid arteries are major blood vessels on either side of your neck. They carry blood to your brain in order to supply it with oxygen and essential nutrients. If blood isn’t flowing through these vessels correctly, then your brain might not be getting everything it needs.

Narrowed or blocked arteries usually happen because of a condition called atherosclerosis. Atherosclerosis causes fatty material to stick to the insides of the arteries. When enough of this material has collected, it can slow down or even stop the blood flow. Atherosclerosis also increases the risk that blood clots could block the blood vessel, which could suddenly stop the blood.

If the blood supply to your brain is blocked or slowed down, then it can have serious effects. The brain cells can run out of oxygen and may die. This is known as a stroke and it can have very serious consequences. A stroke could leave you with long term speech and movement problems. If you don’t get treated quickly, it could even be fatal.

Why Are Carotid Doppler Scans Performed?

Carotid Doppler scans can be used to find out if you’re likely to have a stroke or to help doctors make the right decisions about your care after a TIA or stroke.

Your doctor might recommend that you have this test if you are:

• Are at high risk of stroke, for example, if you have a family history of stroke or ahealth condition such as high blood pressure, high cholesterol or coronary artery disease.
• Want it to be included in your health screening.
• Have had a transient-ischemic attack or mini-stroke
• Have had a stroke
• Recently had surgery on the arteries, for example if plaques were removed or a stent was fitted as part of your stoke treatment

The results of the scan can be very useful. A carotid Doppler scan can help us to understand your stroke risk or to decide on the best course of treatment. If the scan confirms that you are at higher risk of stroke, we might advise some lifestyle changes to help minimise this risk. You might also need treatment to reduce the risk or to reverse the narrowing of your arteries.

Possible treatment options include:

• Medication to reduce your cholesterol levels and blood pressure to prevent the problem from getting worse
• Medication to stop blood clots from forming so that you are less likely to have a stroke
• Surgery to remove plaques from inside the arteries
• Surgery to widen and strengthen the arteries by fitting a stent

Once the treatment has started, your doctor might recommend a follow up scan to check on the results. You should be able to see an improvement in the blood flow that means your stroke risk has been successfully reduced.

Should You Have the Carotid Doppler Scan?

The carotid Doppler scan can be very useful in certain circumstances, but it isn’t always the best test for everyone. You will need to discuss the options with your doctor in order to make the right choices about screening or tests. It’s worth keeping the following points in mind when deciding whether to have a carotid ultrasound:

• Ultrasound is a completely safe, painless and non-invasive test so there are no risks or side effects to worry about.
• Screening tests can tell you if there’s a risk of a certain condition, but the results aren’t perfect. There is a small chance that you could end up worrying and having unnecessary treatment because you seemed to be at high risk, even if you were never going to have a stroke. It’s therefore unwise to have a carotid Doppler scan unless you are in a higher risk group or you’ve already experienced symptoms or a TIA.
• It’s important to know if you are at risk of a stroke as there are steps we can take to reduce the chances that you’ll be affected. Assessing your stroke risk is especially important if you’ve already had a TIA.
• Carotid Doppler scans can be the best way to locate the cause of a TIA or to work out how to treat your condition. It can enable us to perform surgical procedures to ensure your brain continues to get a good blood supply.
• Sometimes other scans or investigations will be needed too in order to get a clearer picture of what’s going on. However, these options can be riskier and some of them require invasive procedures to examine the inside of your arteries. It’s therefore a good idea to try an ultrasound scan first.

You’ll be able to discuss the advantages and disadvantages of this test with your doctor so that you can make the right choice together. The carotid Doppler could help you to get the best care.

Do you have any more advice for people who are considering having a carotid Doppler scan?