Common Carotid, Internal Carotid and Vertebral Artery Doppler Ultrasonography Findings in Patients With Crimean-Congo Haemorrhagic Fever

Objective: The aim of this study was to perform common carotid, internal carotid and vertebral artery Doppler ultrasound imaging of patients with Crimean-Congo haemorrhagic fever (CCHF), to compare the results with those of healthy individuals, and to determine the value of radiological findings in the prediction of disease severity in the early period. Methods: Bilateral common carotid, internal carotid and vertebral artery Doppler ultrasound (US) imaging was performed in CCHF patients and a healthy control group between March 2016 and September 2017. Patients were grouped as mild-moderate or severe cases according to the scoring system of Bakir et al. to determine disease severity. The peak systolic and diastolic rates together with the resistive and pulsatility indexes were examined in the common carotid, internal carotid, and vertebral arteries bilaterally. The flow volumes in the internal carotid and vertebral arteries were also measured bilaterally. Results: Total 35 CCHF patients comprised 14 males and 21 females with a mean age of 52 years. 7 patients were evaluated as severe and 28 as mild-moderate. On Doppler US, the peak systolic and diastolic end flow rates in vertebral arteries bilaterally were found to be statistically significantly higher in the patient group compared to the control group (p<0.05). The internal carotid artery and vertebral artery flow volumes bilaterally were determined to be statistically significantly higher in the patient group (p=0.032). When the relationship between flow volume and disease course was examined, volume was 1.11 L/min in mild-moderate cases and 2.23 L/min in severe cases. Conclusions: Early diagnosis of CCHF is extremely important for the initiation of supportive treatment, prediction of disease severity, and precautions to be taken. The noninvasive radiological findings determined in this study can be considered to contribute to the prediction of the clinical course and severity of CCHF in the early stages.