We prospectively studied patients with acute vertebrobasilar ischaemia to assess the value of Doppler ultrasound compared to cerebral angiography during initial evaluation. Doppler ultrasound was diagnostic in 11 of 14 patients (79%). Transcranial ultrasonic examination yielded important information in addition to extracranial findings in 8 of 11 patients. Depending on the underlying vascular pathology, Doppler ultrasound proved to be a useful screening instrument to support acute management of vertebrobasilar ischaemia. With regard to clinical symptoms and ultrasonic findings, practical consequences for diagnostic evaluation are proposed.
