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Countable and non-countable microembolic signals by TCD in first-ever stroke or TIA patients with PFO

G Telman1, E Kouperberg, E Sprecher

  • 1Department of Neurology, Rambam Health Care Campus, Haifa, Israel. g_telman@rambam.health.gov.il

Journal of the Neurological Sciences
|December 14, 2007
PubMed
Abstract

Insights

Younger patients with patent foramen ovale (PFO) and stroke have cryptogenic strokes more often. However, a large amount of microembolic signals (MES) is not correlated with stroke or TIA in this group.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Patent foramen ovale (PFO) is linked to stroke incidence and recurrence.
  • Microembolic signals (MES) monitored by contrast transcranial Doppler (cTCD) may indicate stroke risk in PFO patients.

Purpose of the Study:

  • To investigate the hypothesis that younger PFO patients with stroke have more artificially induced MES.
  • To compare MES patterns between younger (19-45 years) and older (46-77 years) stroke/TIA patients with PFO.

Main Methods:

  • Analysis of 109 patients with first-ever ischemic stroke or TIA and PFO.
  • Categorization into "younger" (37 patients) and "older" (72 patients) groups.
  • MES measurement using cTCD, with "countable" and "non-countable" (shower) patterns defined.

Main Results:

  • Younger patients had a higher rate of cryptogenic stroke/TIA (62.2% vs. 36.1%).
  • Older patients showed a higher incidence of ischemic heart disease and hyperlipidemia.
  • A "non-countable" MES pattern was more frequent in older patients (p=0.04), but no difference in countable MES numbers was found between groups.

Conclusions:

  • PFOs generating numerous MES are common in older stroke/TIA patients (>45 years).
  • A high number of MES does not correlate with stroke or TIA in younger PFO patients.
  • The study suggests age-related differences in PFO-associated stroke mechanisms.

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