title: 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.
abstract: OBJECTIVE
  Whether hemodynamic and/or embolic transcranial Doppler (TCD) features of internal carotid artery (ICA) stenosis contribute to the classification of stroke patterns on MRI.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Hubertus
authors.initials: H
authors.lastname: Müller
authors.affiliation: Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Fisch
authors.affiliation: Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Aurelien
authors.initials: A
authors.lastname: Viaccoz
authors.affiliation: Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bonvin
authors.affiliation: Department of Radiology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Karl
authors.initials: K
authors.lastname: Lovblad
authors.affiliation: Department of Radiology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Vitor
authors.initials: V
authors.lastname: Cuvinciuc
authors.affiliation: Department of Neurology, University Hospitals of Geneva Medical School, Geneva, Switzerland.
authors.forename: Roman F
authors.initials: RF
authors.lastname: Sztajzel
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis*; D002533:Cerebral Angiography / Q000379:methods; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
keywords: Territorial stroke; cerebral vasoreactivity; hemodynamic stroke; microembolic signals; transcranial Doppler