Vertebral Artery Doppler Ultrasonography: Anatomy, Examination Technique and Clinical Applications

By Denis QIRINXHI, Durim ÇELA, Blerina SARAÇI

Abstract
The vertebral arteries form an essential part of the posterior cerebral circulation,
supplying the brainstem, cerebellum, occipital lobes, and portions of the thalami. In routine neurovascular work, Doppler ultrasonography offers a safe, repeatable, noni-nvasive,
and relatively inexpensive way to assess vertebral artery anatomy and flow patterns. CTA and MRA provide superior anatomic detail, particularly for distal and intracranial segments, but duplex ultrasound remains valuable as an initial and follow-up examination in selected patients with suspected vertebrobasilar disease. This educational article reviews segmental anatomy, scanning technique, expected Doppler parameters, common anatomic variants, vertebral artery hypoplasia, atherosclerotic stenosis, occlusion, dissection, subclavian steal syndrome, frequent interpretive pitfalls, and a practical diagnostic algorithm. The aim is to provide a concise working guide for neurologists, radiologists, residents, and other clinicians involved in cerebrovascular imaging.
Keywords: vertebral artery; Doppler ultrasound; posterior circulation; vertebrobasilar disease; stenosis; hypoplasia; subclavian steal syndrome.