Differentiation between ischemic and hemorrhagic stroke by transcranial color-coded real-time sonography

Area of Science:

• Neurology
• Medical Imaging
• Diagnostic Ultrasound

Background:

• Cerebrovascular disorders, including ischemic stroke and intracerebral hemorrhage, require accurate and timely diagnosis.
• Conventional imaging methods like CT scans are established but may have limitations in certain scenarios.

Purpose of the Study:

• To evaluate the efficacy of transcranial color-coded real-time sonography (TCCS) in the diagnosis and follow-up of patients with ischemic stroke and intracerebral hemorrhage.
• To compare TCCS findings with cranial computed tomography (CT) results.

Main Methods:

• Application of transcranial color-coded real-time sonography in 20 patients with ischemic stroke and 28 patients with spontaneous intracerebral hemorrhage.
• Sonographic visualization of recent hemorrhages as hyperechodense masses and older clots with decreasing echodensity.
• Assessment of vessel occlusion and collateral supply in ischemic infarction using color-B-mode and Doppler modes.
• Depiction of complications such as CSF circulation disturbance and midline shift.

Main Results:

• Sonographic diagnoses closely correlated with cranial CT findings in all patients.
• Recent hemorrhages were clearly distinguished due to high contrast.
• Acute ischemic infarction showed vessel occlusion in 17/20 patients and collateral supply in 10/20.
• TCCS depicted complications of cerebrovascular disorders effectively.

Conclusions:

• Transcranial color-coded real-time sonography is a valuable noninvasive tool for the early differential diagnosis of cerebrovascular disorders.
• TCCS facilitates long-term follow-up of patients with ischemic stroke and intracerebral hemorrhage.
• The technique shows promise in complementing existing diagnostic modalities for stroke and hemorrhage.