Embolic and Hemodynamic Transcranial Doppler Characteristics in Patients with Acute Ischemic Stroke due to Carotid Occlusive Disease: Contribution to the Different Infarct Patterns on MRI
Hubertus Müller MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorLorraine Fisch MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorAurelien Viaccoz MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorChristoph Bonvin MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorKarl Lovblad MD
Department of Radiology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorVitor Cuvinciuc MD
Department of Radiology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorCorresponding Author
Roman F. Sztajzel MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Correspondence: Address correspondence to R. Sztajzel, MD, Neurosonology Unit, Department of Neurology, 24, rue Micheli-du-Crest, 1211 Geneva 14. E-mail: [email protected].Search for more papers by this authorHubertus Müller MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorLorraine Fisch MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorAurelien Viaccoz MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorChristoph Bonvin MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorKarl Lovblad MD
Department of Radiology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorVitor Cuvinciuc MD
Department of Radiology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Search for more papers by this authorCorresponding Author
Roman F. Sztajzel MD
Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland
Correspondence: Address correspondence to R. Sztajzel, MD, Neurosonology Unit, Department of Neurology, 24, rue Micheli-du-Crest, 1211 Geneva 14. E-mail: [email protected].Search for more papers by this authorABSTRACT
BACKGROUND AND PURPOSE
Whether hemodynamic and/or embolic transcranial Doppler (TCD) features of internal carotid artery (ICA) stenosis contribute to the classification of stroke patterns on MRI.
PATIENTS AND METHODS
Consecutive patients presenting symptomatic ≥50% ICA stenosis were included. Microembolic signals (MES) detection and measurement of cerebral vasoreactivity (VR) were performed by TCD. Only acute MRI lesions, territorial (TT) and/or borderzone (BZ) were considered.
RESULTS
A total of 72 ICA stenoses, 27 (38%) moderate (50-69%), and 45 (62%) high grade (70-99%) were included. MRI lesions showed 32 (44%) pure TT, 20 (28%) pure BZ, and 20 (28%) mixed TT and BZ. Impaired VR was found more frequently among patients with higher degrees of stenoses (P < .001) whereas MES were similarly encountered in both groups (P = NS). Impaired VR was more common in the BZ (10/20, 50%) than in the TT group (9/32, 28%, P < .1) while MES were present in 47% (15/32) of patients with TT and in 30% (6/20, P < .1) of those with BZ lesions, in particular in cortical BZ infarcts (P < .02).
CONCLUSION
Our findings suggest that TCD characteristics of the ICA stenosis contribute to better define stroke patterns on MRI in about one-third of the patients presenting with pure TT or BZ lesions.
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