Transcranial Doppler sonography in the acute cerebral ischemic disease

Transcranial Doppler sonography (TCD) is a noninvasive easy-performed method which can be repeated even in critically ill patients. It provides means to diagnose, quantify and monitor individual haemodynamic situation, and, probably, to predict the outcome of stroke. The purpose of this study was to evaluate the usefulness of the TCD in the examination of vascular lesions in the early phase of acute cerebral ischemic disease. The results showed different vascular disturbanies in otherwise homogenous group of patients. The TCD examinations were carried out in 30 patients in the early phase of stroke with presumed lesions in the middle cerebral artery (MCA) irrigation area. CT of the brain showed ischemic lesions of the MCA region in all patients. Additionally, blood flow velocity (BFV) was measured in posterior cerebral artery (PCA), anterior cerebral artery (ACA) and carotid siphon (CS) on both skull sides. On the basis of BFV in MCA, the patients could be apparently divided into three groups. In group I MCA the signal was absent. The patients from group 2 showed severely decreased, moderately decreased or nearly normal BFV in MCA. Group 3 consisted of three patients with increased BFV in MCA. In one of them, in whom a high degree of MCA stenosis was confirmed by angiography, BFV in MCA was extremely increased. The results have shown that TCD examinations in patients with acute stroke could provide additional information about vascular lesions, which are relevant to the course and, probably, the prognosis of the disease.