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July2005 Vol.42 Issue:        2        Table of Contents
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Prolonged TCD Monitoring for Microembolus Detection in Acute Stroke Patients

M. A. Etrebi1, Nevine El Nahas1, Hanaa Abdel Kader2, Mona T. El-Ghoneimy3
Departments of Neurology1, Radiology2, Ain Shams University, Neurosurgery, Cairo University3

ABSTRACT

Microembolism might be a cause for early stroke recurrence. These can present as microembolic signals (MES) on transcranial Doppler (TCD) monitoring. Objectives: To identify the utility of TCD monitoring for the occurrence of MES in the early stages of ischemic stroke. – To determine the different cerebroembolic sources (Carotid, cardiac and MCA) using TCD. Setting: specialized university hospital stoke unit. Patients:  150 consecutive patients were studied, in the first 72 hours after ischemic stroke. 43 patients fitting the inclusion criteria were included and divided into three groups: carotid (10 patients), cardiac (15 patients) and MCA (18 patients) groups. In addition 10 normal controls were studied. Methods: all patients were assessed by a neurologic history and examination, CT on admission, MRI and MRA, ECG, Transthoracic ± transesophageal echocardiography, carotid duplex and TCD monitoring for one hour. Results: 60% of the carotid group showed MES; 66% of whom being in the ipsilateral MCA. 53% of the cardiac group showed MES; 75% being bilateral. Among the MCA group 27% had MES in the symptomatic MCA. MES were not detect in any of the normal controls. Conclusion: TCD is a promising tool for detection of early cerebral embolization in ischemic stroke and might have its implications on therapeutic options.

(Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(2): 291-300).

 





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