title: The Effect of Pulsatility Index on Infarct Volume in Acute Lacunar Stroke.
abstract: OBJECTIVE
  Lacunar stroke, in the context of small vessel disease, is a type of cerebral infarction caused by occlusion of a penetrating artery. Pulsatility index (PI) is an easily measurable parameter in Transcranial Doppler ultrasound (TCD) study. PI reflects distal cerebral vascular resistance and has been interpreted as a surrogate marker of small vessel disease. We hypothesized that an increased PI, a marker of small vessel disease, might be associated with a larger infarct volume in acute lacunar stroke.
  
  
  METHODS
  This study included 64 patients with acute lacunar stroke who underwent TCD and brain MRI. We evaluated the association between the mean PI value of bilateral middle cerebral arteries and infarct volume on diffusion-weighted MRI using univariate and multivariate linear regression.
  
  
  RESULTS
  The mean infarct volume and PI were 482.18±406.40 mm³ and 0.86±0.18, respectively. On univariate linear regression, there was a significant positive association between PI and infarct volume (p=0.001). In the multivariate model, a single standard deviation increase of PI (per 0.18) was associated with an increase of 139.05 mm³ in infarct volume (95% confidence interval, 21.25 to 256.85; p=0.022).
  
  
  CONCLUSIONS
  We demonstrated that PI was an independent determinant of infarct volume in acute lacunar stroke. The PI value measured in acute stroke may be a surrogate marker of the extent of ischemic injury.
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Hanbin
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Se A
authors.initials: SA
authors.lastname: An
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Byeongsoo
authors.initials: B
authors.lastname: Yim
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Jonguk
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Ok Joon
authors.initials: OJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Won Chan
authors.initials: WC
authors.lastname: Kim
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Hyun Sook
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. antithrombus@gmail.com.
authors.forename: Jinkwon
authors.initials: J
authors.lastname: Kim
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery; D011673:Pulsatile Flow / Q000502:physiology; D012189:Retrospective Studies; D059409:Stroke, Lacunar / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017585:Ultrasonography, Doppler, Transcranial; D014655:Vascular Resistance / Q000502:physiology
keywords: Transcranial Doppler; diffusion MRI; lacunar stroke; small vessel disease