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Microembolic signals in acute posterior circulation cerebral ischemia: sources and consequences

Jaechun Hwang1, Suk Jae Kim, Ji Man Hong

  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Stroke
|February 21, 2012
PubMed
Abstract

Insights

Microembolic signals (MES) in acute posterior circulation ischemia are linked to intracranial vertebrobasilar artery (VBA) stenosis. Severe VBA stenosis is a root cause, suggesting embolic mechanisms for stroke.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Cerebrovascular Disease

Background:

  • The clinical significance of microembolic signals (MES) in posterior circulation ischemia is not well understood.
  • Investigating the origins and outcomes of MES in acute posterior circulation cerebral ischemia is crucial.

Purpose of the Study:

  • To determine the sources of microembolic signals (MES) in acute posterior circulation cerebral ischemia.
  • To elucidate the consequences of MES in patients with acute posterior circulation cerebral ischemia.

Main Methods:

  • 140 patients with acute posterior circulation cerebral ischemia were monitored for MES.
  • MES monitoring was performed via the suboccipital window at the basilar artery for 30 minutes.

Main Results:

  • MES were detected in 12.9% of patients.
  • Intracranial vertebrobasilar artery (VBA) stenosis was independently associated with MES presence (OR, 9.85; P=0.032).
  • Severe VBA stenosis showed a higher frequency of MES compared to nonsignificant stenosis (OR, 9.88; P=0.031).
  • In a subgroup, MES-positive patients had more embolic infarction and multiple lesion patterns.

Conclusions:

  • Intracranial and severe VBA stenosis are associated with MES in acute posterior circulation ischemia, likely serving as their source.
  • The presence of MES in VBA stenosis indicates embolic mechanisms, leading to multiple infarctions.

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