Abstract
Introduction: Stroke is life threatening & debilitating neurological disease, defined as focal neurological deficit of sudden onset lasting >24 hours & vascular in origin. Significant association between ischemic type of stroke with carotid artery disease seen, more prevalent with carotid artery stenosis. 
 Objectives: This study was done to show association between extracranial carotid artery disease & cerebrovascular accidents (CVAs) with the help of Color Doppler Sonography (CDS). The association between carotid artery disease with associated risk factors were also assessed. 
 Methodology: In this ethically approved prospective study, carotid CDS was done in 79 consecutive patients with diagnosis of acute ischemic stroke (AIS). The various parameters studied included peak systolic velocity (PSV) of internal carotid artery (ICA) & common carotid artery (CCA), ICA/CCA PSV ratio & plaque characteristics. The data collected was analyzed with appropriate statistical test of significance was calculated. 
 Results: Total 79 patients with AIS included out of which 53 were males & 26 were females. The most common presenting complains were hemiparesis (30.4%) & most commonly associated risk factors included hypertension (62.02%). Right sided strokes were most common (44.3%) & middle cerebral artery was most commonly involved vascular territory. Significant stenosis (≥50%) of carotid artery was seen in 27 patients with ICA most common site (45.8%) for plaque formation. Bilateral carotid artery involvement (52.1%) with hypoechoic echotexture of atheromatous plaques (46.6%) was most responsible for significant stenosis & increased intima media thickness. Increased value of PSV & EDV was seen in the stenotic area in the proportion of stenosis with increased PSV ICA/CCA ratio of more than three indicates >60% stenosis. 
 Conclusion: The present study showed well documented role of carotid doppler in detection of site & extent of carotid artery stenosis due to atheromatous plaques of various characteristics playing critical role in thromboembolic phenomenon responsible for development of stroke.
Highlights
Stroke is third leading cause of death worldwide a er malignancies and cardiac disease and is defined as focal neurological deficit of sudden onset las ng for more than 24 hours with cause being vascular origin.[1]
Significant stenosis (≥50%) of caro d artery was seen in 27 pa ents with internal caro d artery (ICA) most common site (45.8%) for plaque forma on
Increased value of peak systolic velocity (PSV) & end diastolic velocity (EDV) was seen in the steno c area in the propor on of stenosis with increased PSV ICA/common caro d artery (CCA) ra o of more than three indicates >60% stenosis
Summary
Stroke is third leading cause of death worldwide a er malignancies and cardiac disease and is defined as focal neurological deficit of sudden onset las ng for more than 24 hours with cause being vascular origin.[1]. About one third cases are severe & prolonged or irreversible disabili es seen in survivors. About 80-85% of strokes are thromboembolic in origin leading to ischemic cerebral infarct & ischemia with atherosclero c plaques involving both extra cranial & intra cranial caro d arteries ac ng as source of thrombus. Hemorrhagic causes of stroke include subarachnoid hemorrhage & intra cranial hemorrhage accoun ng of 15-20% of total stroke cases. Severe stenosis of caro d artery, large artery lesions, diabetes mellitus, asymptoma c atherosclero c plaques or combina ons of these risk factors are causes for large artery involvement in stroke.[6] Hemorrhagic causes of stroke include subarachnoid hemorrhage & intra cranial hemorrhage accoun ng of 15-20% of total stroke cases. 3 It is seen that within three months of TIA, there is chance of major stroke and about 20% major stroke was preceded by TIA.[4,5] Severe stenosis of caro d artery, large artery lesions, diabetes mellitus, asymptoma c atherosclero c plaques or combina ons of these risk factors are causes for large artery involvement in stroke.[6]
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