Do not request a Duplex scan of the carotid arteries for vertigo, tinnitus, headache, neck pain, unless there are neurologic signs.

Type of practice


Topic Area

Vascular Surgery

Symptoms of cerebrovascular insufficiency are often confused with those of other diseases. Furthermore, the term Transient Ischemic Attack (TIA) is often used inappropriately. It should be reserved only for a sudden, focal neurologic attack lasting less than 24 hours, due to cerebral ischemia. Without focal signs the patients will undergo a useless Duplex scan of the carotid arteries that may confuse the issue.


1. ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. JACC 2011; 57(8): e16-94.
2. SPREAD – Stroke Prevention and Educational Awareness Diffusion. VII Edizione. Ictus cerebrale: linee guida italiane di prevenzione e trattamento. Raccomandazioni e sintesi. Stesura del 14 marzo 2012.
3. Setacci C, Argenteri A, Cremonesi A, De Donato G, Galzerano G, Lanza G, Navarretta F, Pulli R, Ricci S, Sbarigia E, Setacci F, Sirignano P, Peinetti F, Speziale F. Guidelines on the diagnosis and treatment of extracranial carotid artery stenosis from the Italian Society for Vascular and Endovascular Surgery. J Vasc and Endovasc Surg 2014; 21: 31-42.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.