You are the RT working in the emergency department in a rura…

You are the RT working in the emergency department in a rural hospital (at sea level). A healthy 60-year-old woman was brought to the emergency department in a comatose state, breathing very shallowly. Her family stated that she had taken an overdose of sleeping pills. Arterial blood gases, were obtained while she was breathing room air, revealed a PaO2 of 55 mm Hg, a PaCO2 of 70 mm Hg, and pH of 7.15.  The physician has asked you to calculate the PA02, choose the closest result to your findings below. 

Your carotid duplex study documents an occluded right ICA on…

Your carotid duplex study documents an occluded right ICA on a 72 y.o. female.  The left ICA has a 50-69% diameter reduction based on flow velocities.  What is the most likely explanation for the antegrade flow detected in the right anterior cerebral artery (ACA) with TCD?