Prognostic and diagnostic value of global cerebral blood flow volume and cerebral transit time in acute stroke.
Conventional duplex sonography is a well-established method for the assessment of the brain-supplying arteries in acute stroke. However, ultrasound (US) remains inconclusive in a significant number of stroke patients. Recently, two new US parameters, the cerebral transit time (cTT) and the global cerebral blood flow volume (CBF), have been introduced. In the present study, we investigated the diagnostic and prognostic value of both parameters in stroke patients. Conventional duplex examinations of the extra- and intracranial brain-supplying arteries and measurement of cTT and CBF were performed in 50 consecutive stroke patients within 24 h after symptom onset and compared with US findings in 22 age-matched healthy controls. Neurological deficits and the degree of disability were graded using several stroke scores, and were re-evaluated for outcome measure after 1 year. CBF and cTT were not assessable in 26% and 20% of the patients, respectively. Compared with the healthy control group, stroke patients showed a significant reduction of CBF and prolongation of cTT. More than 50% of patients with otherwise normal routine duplex examination had abnormal CBF or cTT findings. Furthermore, there was a strong correlation between the reduction of global CBF and the outcome after 1 year. Sonographic assessment of the CBF and cTT are additional parameters that might increase the diagnostic sensitivity of US in stroke patients, and may have prognostic relevance.
Ruprecht-Dörfler
Petra
P
Department of Neurology, Bayerische Julius-Maximilians-Universität, Würzburg, Germany.
Brechtelsbauer
Dirk
D
Schliesser
Mira
M
Puls
Imke
I
Becker
Georg
G
D000208:Acute Disease; D000368:Aged; D001776:Blood Circulation Time; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods