Hi, Bill, I am unfortunately not able to help as far as pointing you to any literature. I can only add that I've seen HITS in extracranial and peripheral exams. It didn't always turn out to be the heart. One gentleman had shaggy build up along his aortic arch that was launching everywhere. My only opinion is that if you already know what a HITS looks/sounds like, then that's most likely what it was. My experience with techs that have no experience with TCD is that they don't recognize them. But once you know a HITS, you know it.
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