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A pilot study of microembolic signals in patients with middle cerebral artery stenosis
1Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. ks-wong@cuhk.edu.hk
Objective:
There has been limited data on the frequency of microembolic signals in patients with middle cerebral artery (MCA) stenosis, especially during the acute phase of stroke. Using transcranial Doppler, the authors prospectively monitored the MCA segments distal to stenosis in 4 groups of patients for 30 minutes: (1) symptomatic patients with acute ischemic stroke and MCA stenosis, (2) asymptomatic group patients with asymptomatic MCA stenosis, (3) control patients with acute ischemic stroke of undetermined etiology, and (4) normal people. A total of 60 patients completed the study. There were no microembolic signals in the asymptomatic, control, and normal groups. Among 20 patients in the symptomatic group, microembolic signals were detected in 3 patients (15%). The number of emboli ranged from 1 to 6 per 30 minutes. This is the first report of the presence of microembolic signals in acute stroke patients with MCA stenosis.
Insights
Microembolic signals were detected in 15% of acute stroke patients with middle cerebral artery (MCA) stenosis. No signals were found in asymptomatic stenosis, stroke controls, or healthy individuals, highlighting MCA stenosis as a potential source of emboli.
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Disease
Background:
- Limited data exists on microembolic signal (MES) frequency in middle cerebral artery (MCA) stenosis, particularly during acute stroke.
- Understanding MES in MCA stenosis is crucial for stroke etiology determination and management.
Purpose of the Study:
- To investigate the presence and frequency of MES in the MCA distal to stenosis in different patient groups.
- To determine if MES are associated with acute ischemic stroke in the context of MCA stenosis.
Main Methods:
- Prospective monitoring of MCA segments using transcranial Doppler (TCD) for 30 minutes.
- Inclusion of four groups: symptomatic acute ischemic stroke with MCA stenosis, asymptomatic MCA stenosis, stroke controls, and healthy individuals.
- Total of 60 patients evaluated.
Main Results:
- No MES were detected in asymptomatic MCA stenosis, stroke control, or healthy groups.
- MES were identified in 3 out of 20 patients (15%) with symptomatic acute ischemic stroke and MCA stenosis.
- The number of detected emboli ranged from 1 to 6 per 30-minute monitoring period.
Conclusions:
- This study is the first to report the presence of MES in patients experiencing acute stroke with MCA stenosis.
- Symptomatic MCA stenosis is associated with MES, suggesting it as a potential source of cerebral embolism in acute stroke.
- Further research is warranted to explore the clinical implications of MES in MCA stenosis.