TCD and Cerebral Circulation Practice Test

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• What does a unilateral high velocity in the MCA with a normal contralateral velocity and a clean spectral trace most likely indicate?
• What should clinicians do if serial TCD measurements show velocities rising over time despite treatment?
• Which artery courses posteriorly and medially from the internal carotid artery?
• Which artery provides collateral flow between posterior and anterior circulations?
• Which artery is commonly associated with fenestration in this context?
• What does PCoA stand for?
• Which vessels are evaluated with the transtemporal window?
• What does the artery providing collateral circulation demonstrate on Doppler imaging?
• In Moyamoya disease, what is a characteristic transcranial Doppler finding?
• Which vessels form the anterior circulation of the brain?
• Where is the transtemporal window placed?
• Which window is used to evaluate the vertebrobasilar system in imaging protocols described?
• How is the basilar artery formed?
• Which pattern on transcranial Doppler would most strongly suggest microvascular or distal resistance rather than proximal stenosis?
• Which factors influence the ability to penetrate the temporal bone?
• How are Pulsatility Index and Resistance Index calculated, and what does a higher value imply?
• What is the role of serial TCD in monitoring vasospasm therapy alongside hypervolemia or other interventions?
• How many segments does PCA have, and which is evaluated during TCD?
• Which vascular system is evaluated with the suboccipital window?
• What action is most appropriate if TCD velocities rise during days 3–14 after SAH and the patient is hemodynamically stable?
• How do autoregulation and CO2-induced changes affect transcranial Doppler velocity patterns?
• What is the function of the anterior communicating artery within the Circle of Willis?
• Which of the two terminal branches of the internal carotid artery is a rare site for stenosis or occlusion?
• The circle of Willis permits communication between which hemispheres via the anterior communicating artery?
• What is the consequence of mislabeling vessels during TCD interpretation?
• What are three key limitations of TCD compared with CT or MR angiography?
• Which arteries are commonly sampled via the transtemporal window to assess anterior and posterior circulation?
• How does the ophthalmic artery display and what is its mean velocity?
• Which range best represents the MCA main trunk velocity given mean 62 +/- 12 cm/sec?
• Which artery is the largest branch of the vertebral artery and supplies the inferior aspect of the cerebellum?
• Intracranial arterial velocities reflect which physiologic parameter?
• What is the main clinical use of serial transcranial Doppler measurements after a suspected vasospasm risk event?
• Which pairing of window and vessel is correctly matched?
• How does CO2 tension affect cerebral blood flow and MFV on transcranial Doppler?
• What does spectral broadening indicate, and in what conditions might you see it on TCD?
• What does ACoA stand for?
• The ophthalmic artery is the first branch of which major arterial system?
• If a transcranial Doppler shows a focal high velocity in one intracranial artery with normal velocities elsewhere and no spectral broadening, which pattern is most likely?
• How should baseline drift be managed during TCD measurements?
• Cerebral vasospasm is a known complication of which condition?
• Hypocapnia is defined as which of the following?
• Which waveform features on transcranial Doppler suggest intracranial stenosis?
• Which arteries supply blood to the brain posteriorly?
• Which vessels are evaluated with a transorbital window?
• What is the lower bound of VA velocity given 38 +/- 10 cm/sec?
• What knowledge is necessary for TCD?
• What landmarks are used to locate the vertebrobasilar system in the suboccipital approach?
• Which window would you use to insonate the vertebrobasilar system and at what approximate depths are the vertebral and basilar arteries seen?
• Which waveform feature is most suggestive of intracranial stenosis on transcranial Doppler?
• What is the patient position for a transorbital window?
• How many segments does the middle cerebral artery have?
• The anterior communicating artery connects which arteries?
• How is the size of A1 segment related to the size of ACoA?
• On transcranial Doppler, what MCA MFV thresholds indicate probable and severe vasospasm?
• Which arteries constitute the posterior circulation?
• How does the distal internal carotid artery typically appear on color Doppler when flow is away from the transducer?
• Which circumstances are associated with reduced diastolic flow and higher resistance on transcranial Doppler?
• How do you distinguish post-stenotic turbulence from normal flow on a spectral Doppler trace?
• Which artery courses anterolaterally and passes through the optic foramen?
• Which option is NOT a window used for imaging cerebral vessels?
• In transcranial Doppler, the main trunk of the MCA is usually directed toward the transducer.
• What makes up the blue Y in the vertebrobasilar system display?
• Which statement best describes the supply territory of the ophthalmic artery?
• What originates from the terminal basilar artery?
• What does cerebral vasospasm contribute to in terms of patient outcomes?
• Which artery is the largest branch of the subclavian artery?
• Which statement about the ophthalmic artery is true?
• In sickle cell disease, cerebral infarction is most strongly associated with occlusive vasculopathy affecting which arteries?
• How does the vertebrobasilar system display on color Doppler?
• In cerebral imaging, which artery is commonly used as a midline landmark?
• Which arteries are the terminal branches of the internal carotid artery?
• How do hematocrit and blood viscosity influence TCD velocity readings?
• Which vessels are commonly involved in vertebrobasilar vasospasm and may show elevated MFV on transcranial Doppler?
• How does age-related skull bone thickness affect TCD diagnostic accuracy?
• Which of the following best defines hypercapnia?
• Which window is used to examine the ophthalmic artery and carotid siphon?
• Which approach provides access to the vertebrobasilar system by locating landmarks near the foramen magnum?
• Which window evaluates the distal ICA?
• Which parameter best describes intracranial arterial velocity in transcranial Doppler studies?
• TCD imaging interpretation is derived from which signal component?
• Subarachnoid hemorrhage is most commonly caused by which mechanism?
• In a typical color Doppler map, which color represents flow toward the transducer in the ACA?
• Which artery completes the trio of collateral pathways alongside ACoA and the ophthalmic artery?
• What is the Lindegaard ratio and how is it used in TCD interpretation?
• The segments M1 through M4 refer to which artery?
• What is the polygon-shaped vascular ring at the base of the brain?
• What is the first branch of the internal carotid artery?
• What is the role of transcranial Doppler in sickle cell disease management for stroke risk stratification?
• What are the blood flow direction and mean velocity observed in the terminal internal carotid artery (ICA)?
• What is the typical normal range for MCA MFV in adults, and how do PCA and ACA velocities compare?
• What is the typical transducer frequency used in TCD and why?
• What kind of transducer is used for TCD?
• Which of the following is NOT a limitation of transcranial Doppler?
• Which of the following are common pitfalls in vessel identification and velocity interpretation during transcranial Doppler?
• Basilar artery is formed by union of which arteries?
• Which vessel is formed by the fusion of the vertebral arteries and runs along the brainstem?
• Which vessels constitute the three main collateral pathways?
• What is the vasoconstriction of the arteries called?
• Which vessels comprise the posterior circulation and how are they accessed with transcranial Doppler?
• What is the A1 segment of the ACA?
• Pulsatility Index and Resistive Index on transcranial Doppler measure what property of the cerebral circulation?
• How can you differentiate focal intracranial stenosis from global cerebral hyperemia on transcranial Doppler?
• If TCD suggests unilateral intracranial stenosis, which imaging modality should be used to confirm the finding?
• Which arteries constitute the posterior circulation of the brain?
• What should be ensured for data accuracy when taking MCA velocity measurements?
• Which artery is the largest branch of the vertebral artery?
• What is the typical velocity pattern in the posterior circulation during vasospasm?
• Which imaging window is used as a continuation of extracranial distal ICA imaging?
• What is the mean velocity value associated with the anterior cerebral artery in the provided data?
• What is the primary purpose of TCD as described in the material?
• What are signs of complete artery occlusion on TCD?
• What vessels are evaluated with a submandibular window?
• What does MFV stand for in transcranial Doppler and what does it measure?
• In cases of extensive bilateral extracranial occlusion, which artery can serve as a collateral pathway?
• What is the mean velocity in the basilar artery?
• What supports confirming intracranial stenosis beyond velocity data?
• How do the PCA course?
• Why is ophthalmic artery velocity not used as a sole diagnostic marker for intracranial perfusion?
• On transcranial Doppler, which description best distinguishes vasospasm from reversible cerebral vasoconstriction syndrome (RCVS)?
• The posterior communicating artery connects the internal carotid artery to which artery in the posterior circulation?
• Which arteries arise from the internal carotid system in the anterior circulation?
• Which arteries constitute the anterior cerebral circulation and how are they connected within the Circle of Willis?
• What does TCD stand for?
• Which intracranial vessels are accessible via the transtemporal window besides the MCA?
• What is recorded on the horizontal and vertical axis in TCD?
• Cerebral infarction in sickle cell disease is associated with occlusive vasculopathy involving which territories?
• The anterior communicating artery connects which arteries across the interhemispheric fissure?
• How should MCA velocity be interpreted when the patient has a tachycardia or irregular rhythm?
• Which vessels are evaluated with the transorbital window?
• Which approach is used to access intracranial vessels for TCD procedures?
• What is the most common cause of subarachnoid hemorrhage?
• Which artery is described as a short vessel connecting the A1 segments across the interhemispheric fissure?
• Which imaging is performed before TCD to assess extracranial disease?
• Hypocapnia is defined as which of the following?
• Which statement about window-based imaging is incorrect?
• Which imaging modality provides definitive confirmation of intracranial stenosis after transcranial Doppler suggests stenosis?
• What is the mean velocity of the MCA main trunk?
• What is the mean velocity of the VA?
• What is the significance of ophthalmic artery velocity in TCD?
• Which statement about documenting baseline velocities and repeated measures is correct?
• Cerebral vasospasm peaks timing after aneurysmal subarachnoid hemorrhage and typical duration?
• In pediatric screening for stroke risk in sickle cell disease, what MCA velocity threshold prompts consideration of exchange transfusion?
• The suboccipital window primarily assesses which vascular system?
• How is the Tx placed for a submandibular window?
• In transcranial Doppler, how does the PCoA display and what is its mean peak velocity?
• How does the presence of severe carotid stenosis affect intracranial velocities on TCD?
• When does the PCoA function as a collateral pathway?
• What are the two terminal branches of the internal carotid artery?
• In transcranial Doppler, which window is used to evaluate the MCA and at what depth is the M1 segment typically found?
• How does transcranial Doppler complement CTA/MRA in evaluating intracranial vascular disease?
• What are microembolic signals on transcranial Doppler and what is their clinical significance?
• How can transcranial Doppler differentiate vasospasm from global cerebral hyperemia after subarachnoid hemorrhage?
• How does hypoventilation affect the middle cerebral artery in terms of mean velocity and pulsatility index?
• What are the three primary spectral Doppler measurements used in TCD and what does each represent?
• What spectral pattern is most consistent with high-grade vasospasm on TCD?
• What is done before TCD and why?
• Which of the following is NOT a common cause of false-positive elevated velocities on transcranial Doppler (TCD)?
• What are typical transcranial Doppler findings in Moyamoya disease?
• The anterior communicating artery connects which arteries?
• Which arteries supply blood to the brain anteriorly?
• In color Doppler displays, what does the 'Blue Y' indicate in relation to the transducer?
• Which vessels are evaluated with the submandibular window?
• What is the typical Doppler display and mean velocity for the anterior cerebral artery (ACA)?
• How does hyperventilation affect the MCA?
• Which vessels are evaluated with a suboccipital window?
• What structure lies deep to the vertebral artery?
• How can TCD be used during neurosurgical procedures for real-time flow assessment?
• Which arteries communicate to form the Circle of Willis?
• What is post-stenotic turbulence on transcranial Doppler?
• Which window is used to evaluate the terminal ICA, main trunk of MCA, ACA, and PCoA?
• Which common anatomic variants of Circle of Willis can affect TCD interpretation?
• Which MFV pattern and Lindegaard ratio characterize global hyperemia after subarachnoid hemorrhage?
• In color Doppler imaging, flow toward the transducer is displayed in which color?
• What color coding is used to represent the ophthalmic artery as a collateral pathway, indicating movement away from the treatment site?
• What term describes the polygon-shaped vascular ring at the base of the brain formed by major arteries?
• Velocity is recorded in what unit?
• Why is sample volume placement important for accurate velocity measurement in transcranial Doppler?
• Which artery connects the two anterior cerebral arteries?
• Which artery is abbreviated as PCoA?
• The circle of Willis permits communication between which two cerebral systems?
• Which of the following scenarios best indicates the presence of vasospasm on TCD?
• Fenestrated vessels are described as which of the following, according to the material?
• What is the patient position for the transtemporal approach?
• Which option best describes the blood flow permitted by the posterior communicating artery (PCoA)?
• The PCoA joins to which artery?
• Which artery serves as a conduit between the external carotid system and the intracranial internal carotid system via the orbit?
• What might a mismatch between abnormal transcranial Doppler velocities and absence of focal stenosis on CTA/MRA indicate?
• Branches of the ophthalmic artery include which?
• What is the Lindegaard ratio and how is it interpreted in vasospasm evaluation after SAH?
• What is the role of serial transcranial Doppler monitoring after subarachnoid hemorrhage (SAH) in guiding therapy?
• Which window provides visualization of the intracavernous carotid siphon and ophthalmic artery?
• The proximal horizontal segment is connected to which structure via which arterial connection?
• What is the patient position for a suboccipital approach?
• Why is transcranial Doppler not a substitute for catheter angiography in diagnosing intracranial stenosis?
• What is the recommended frequency and duration of TCD monitoring in high-risk SAH patients?