Short-term prognosis of stroke due to occlusion of internal carotid artery based on transcranial Doppler ultrasonography.
OBJECTIVE
The clinical course of stroke due to occlusion of the internal carotid artery is influenced by amount of collateral flow. We measured mean frequency shifts in the middle cerebral artery by transcranial Doppler ultrasonography to determine its prognostic value.


METHODS
Patients with proven extracranial occlusion of the internal carotid artery and ipsilateral hemispheral stroke were enrolled in our study. We performed transcranial Doppler ultrasonography on 31 patients within 48 hours after the stroke onset and followed up 25 patients in 28 days. At the same time, neurological examination with quantification of neurological deficit was done. We correlated values of flow frequency shifts on the side of stroke with degree of neurological deficit at the onset and at 28 days as well as the degree of clinical improvement and the value of frequency shifts.


RESULTS
We found a negative correlation between blood flow frequency shifts in the middle cerebral artery and degree of neurological deficit at the onset (Spearman rank correlation coefficient, -0.567; p less than 0.001). We also found a positive correlation between the change of the neurological deficit during follow-up and frequency shifts at the onset (Spearman rank coefficient, 0.548; p less than 0.05).


CONCLUSIONS
Diminished blood flow velocity (mean frequency shift) in the area of stroke is a negative prognostic factor for the degree of neurological deficit at the onset and a negative prognostic factor for possible improvement. Knowledge of hemodynamic conditions in the stroke area may help to improve therapeutic decisions.
Hedera
P
P
Department of Neurology, Medical School of Comenuis University, Bratislava, Czechoslovakia.
Traubner
P
P
Bujdáková
J
J
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011379:Prognosis; D011673:Pulsatile Flow; D014463:Ultrasonography