Early Anterior Temporal Artery Can Masquerade as Patent Middle Cerebral Artery on Transcranial Doppler in Acute Ischemic Stroke

The anterior temporal artery (ATA) is the first branch of the middle cerebral artery (MCA). This branch can alter the morphology of the MCA waveform when the MCA is sampled proximal to an occlusion. When present, it can result in spurious interpretation of the Transcranial Doppler (TCD) as a normal study in a patient with M1 occlusion. Here we describe TCD findings in a patient with M1 MCA occlusion with an early ATA branch.