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Micro embolic signals in patients with cerebral ischaemic events
D Gucuyener1, N Uzuner, S Ozkan
1Department of Neurology, Osmangazi University, Meselik 26480, Eskisehir, Turkey. DEMETG@mail.koc.net
Abstract:
The aim of this study was to evaluate the occurrence of micro embolic signals (MES) in patients with a cerebral ischaemia using transcranial doppler monitoring and to find out its diagnostic relevance. We prospectively performed bilateral multigated transcranial doppler monitoring from both middle cerebral arteries in 359 patients with an acute or recent (<4 weeks) cerebral ischaemic event, and in 182 control subjects without a cerebral ischaemic event. MES were analysed according to the standardised protocol. Patients with cerebral ischaemic events had a significantly higher (p<0.00001) rate of MES occurrence (31.8%) than control subjects (5.5%). MES were detected significantly higher in patients with partial or total anterior circulation infarcts (39.1%) than in those with lacunar infarcts (26.0%) or transient ischaemic attacks (27.3%). A correlation of MES and neuroimaging finding was also tried. TCD was found to have a predictive role in microemboli monitoring, predominantly in patients with large vessel territory infarction.
Insights
Microembolic signals (MES) are more frequent in patients with cerebral ischemia, detected via transcranial Doppler (TCD) monitoring. This diagnostic tool shows predictive value, especially for large vessel territory infarcts.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Cerebral ischemia poses a significant health risk.
- Microembolic signals (MES) are potential indicators of ischemic events.
- Transcranial Doppler (TCD) monitoring is a non-invasive technique for assessing cerebral blood flow.
Purpose of the Study:
- To evaluate the occurrence of MES in patients with cerebral ischemia.
- To determine the diagnostic relevance of MES using TCD.
- To explore the correlation between MES and neuroimaging findings.
Main Methods:
- Prospective study involving 359 patients with acute/recent cerebral ischemic events and 182 controls.
- Bilateral multigated TCD monitoring of middle cerebral arteries.
- Standardized analysis of MES detection.
Main Results:
- Significantly higher MES occurrence in patients with cerebral ischemia (31.8%) compared to controls (5.5%) (p<0.00001).
- MES detection rates varied by infarct type: anterior circulation infarcts (39.1%), lacunar infarcts (26.0%), and transient ischemic attacks (27.3%).
- TCD demonstrated a predictive role in microemboli monitoring, particularly in large vessel territory infarction.
Conclusions:
- TCD monitoring effectively detects MES in patients with cerebral ischemia.
- MES occurrence is significantly associated with cerebral ischemic events.
- TCD monitoring holds diagnostic relevance for identifying microemboli, especially in large vessel territory infarcts.