Clinical Consultation – Carotid Plaque
From: William J Owens Jr DC DAAMLP
This was a patient that I had come in last week post MVA. He had demonstrable plaquing on the lateral cervical spine radiograph anterior to C3 and C4 vertebral bodies. His main complaint was pain over the left occipital area, 7/10 with headaches. History was negative for dizziness, visual disturbances, nausea or loss of balance. Provokative maneuvers for vasular compromise were negative for any changes related to vascular compromise. My concern is that a piece of the calcification could break off and lodge in the brain as the vaculature gets narrowed, I wanted to evaluate the current patency of the carotid vessels. That is done through a Carotid Doppler Ultrasound. This gives you an idea of the opening as well as any potential turbulance of the blood inside. This patient will never receive a HLVA from me, we are using instrument adjusting only. The first pic is his x-ray and the second is a screen shot from the Doppler with the report. This is ordered through the PCP, I called their office and sent over my initial report, the radiograph report and a request for the doppler.
CAROTID DOPPLER ULTRASOUND:
CLINICAL INDICATIONS: Calcifications on C spine x-ray. High blood pressure. Hyperlipidemia. Comparison study: None.
FINDINGS: Bilateral carotid color duplex ultrasound evaluation was performed. Real time images were obtained utilizing B-mode color flow Doppler to evaluate the vascular structures with waveform analysis.
There are a few plaques in the distal left common carotid artery and bilateral carotid bifurcations.
Peak systolic velocity recorded in the right internal carotid artery is 95 cm/second and in the left internal carotid artery 84 cm/second indicating 20-40% vascular stenosis that is not hemodynamically significant.
Both vertebral arteries are patent with antegrade flow.
MILD ATHEROSCLEROTIC VASCULAR PLAQUE DISEASE WITH NO EVIDENCE OF HEMODYNAMICALLY SIGNIFICANT VASCULAR STENOSIS.