title: The preoperative assessment of stroke risk in lesions involving the internal carotid artery.
abstract: Patients with vascular or tumourous lesions involving the internal carotid artery are at risk of damage or occlusion of this vessel during surgical or endovascular procedures. To assess the stroke risk transcranial Doppler aided carotid compression tests were performed in 82 patients. Based on changes of blood flow velocity (BFV), pulsatility index, systolic/diastolic ratio and length of transient hyperaemic response three groups could be differentiated. Patients in group A (31%) showed only a slight reaction of BFV and were at minimal risk in case of carotid occlusion. Patients in group B (52%) underwent a distinct decrease of Doppler readings with partial improvement and were considered to have moderate to high stroke risk. In group C patients (17%) trial occlusion caused a dramatic reduction of BFV with no recovery (p < 0.01), which denotes a very high stroke risk. Transcranial Doppler aided carotid occlusion manoeuvres provide useful information on cerebrovascular collateral capacity and prognosis of stroke risk.
authors.affiliation: Department of Neurosurgery, Mainz University School of Medicine, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Ungersböck
authors.forename: H
authors.initials: H
authors.lastname: Böcher-Schwarz
authors.forename: W
authors.initials: W
authors.lastname: Müller-Forell
authors.forename: J
authors.initials: J
authors.lastname: Maurer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000601:surgery; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000517:prevention & control*; D003971:Diastole / Q000502:physiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011673:Pulsatile Flow / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors; D013599:Systole / Q000502:physiology; D017585:Ultrasonography, Doppler, Transcranial; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery