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Transcranial Color‐Coded Duplex Sonography of the Middle Cerebral Artery

Routine sonography of the middle cerebral artery in acute ischemic stroke usually focuses on the main stem (M1 segment). However, stenoses and occlusions affect not only proximal but also more distal vessel branches, such as the M2 segments. Transcranial color‐coded duplex sonography allows visualization of these segments; however, a formal analysis and description of normal blood flow values are missing. The purpose of this study was to analyze middle cerebral artery branching patterns with transcranial color‐coded duplex sonography and to establish reference flow velocity values in the detectable M2 branches as well as the early temporal M1 branch.