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Show Journal of Clinical Neuro- ophthalmology 10( 4): 304-- 306, 1990. Letters to the Editor The Use of a Doppler Flow Meter to Identify the Course of the Temporal Artery To the Editor: A temporal artery biopsy is a necessary step in establishing a diagnosis of temporal arteritis. To perform this surgery, the course of the artery must be established, generally by palpation. In some individuals, attenuation of the artery or thickening of the skin may make palpation difficult. Attempts have been made in our clinic to perform temporal artery biopsies on patients in whom extreme difficulty is encountered in palpating the temporal artery. We have found the portable Doppler Flow Meter ( Model 841, Parks Medical Electronics, Beaverton, OR, U. S. A.) to be quite useful in outlining the course of the temporal artery. This takes only minutes and requires no invasive procedure ( Fig. 1). A cut- down is subsequently performed over the area marked out using the Doppler Flow Meter, and the temporal artery is easily found and biopsied. Accurate mapping of the course of the temporal artery is a necessary step before cut- down and ultimate biopsy. In individuals at risk for temporal arteritis this can often be quite difficult using typical manual palpation technique. Therefore, we recommend that a simple, safe, and accurate tech- FIG. 1. The portable Doppler Flow Meter. 304 © 1990 Raven Press. '"'.. j , ew York nique for mapping the course of the tempor~ l artery be available to the clinicians. In our expenence the Doppler Flow Meter is inexpensive,. readil. y available, and quite accurate for performmg thIS measurement. Richard L. Beckman, M. D. Benjamin M. Hartmann, M. D. Department of Ophthalmology Henry Ford Hospital Detroit, Michigan Treatment of Exercise- Induced Transient Visual Events To the Editor: A recent article by Imes and Hoyt ( 1) concerning exercise- induced transient visual events elegantly described a clinical condition, but did not mention therapy. The article reminded us of one patient under our care whose symptoms essentially disappeared on treatment. A 45- year- old man was referred for neuroophthalmologic evaluation in 1981 because of transient visual abnormalities he described as " whiteouts." These attacks generally occurred when he began to play tennis. They developed in crescendo fashion over a matter of seconds, persisted for about 5 min if he sat down, and then faded away. He described the visual abnormality as dazzling, rather than the absence of vision; he could continue to play tennis during the attack, but poorly. The symptoms seemed to come from both eyes and were not confined to a homonymous visual field. The problem had been present for a long time, with the first severe episode occurring while he was playing tennis in college. In retrospect, he thought that he had similar problems beginning at age eight or nine. The year before he was seen, he sustained an ischemic cerebral infarct stroke involving the right side of his body and his speech. As he recovered, the only residual defect was a right superior homonymous quadrantanopsia. An arteriogram per- |
