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Microembolic signals predict cerebral ischaemic events in patients with moyamoya disease

J Chen1, L Duan, W-H Xu

  • 1Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

European Journal of Neurology
|March 8, 2014
PubMed
Abstract

Insights

Microembolic signals (MESs) detected by transcranial Doppler in moyamoya disease patients predict future strokes and transient ischemic attacks (TIAs). MES presence indicates higher risk, aiding in patient management.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Moyamoya disease is characterized by progressive stenosis of intracranial arteries.
  • Microembolic signals (MESs) are detectable via transcranial Doppler in moyamoya disease patients.
  • The clinical significance of MESs in moyamoya disease requires further elucidation.

Purpose of the Study:

  • To investigate the predictive value of MESs for cerebral ischemic events in moyamoya disease.
  • To determine if MES detection aids in risk stratification for stroke and TIA.

Main Methods:

  • Fifty-four moyamoya disease patients underwent 30-minute transcranial Doppler monitoring of bilateral middle cerebral arteries.
  • Patients were followed for 1 year to record cerebral ischemic events (stroke, TIA).
  • Logistic and Cox regression analyses were used to assess the association between MESs and ischemic events.

Main Results:

  • MESs were detected in 20.4% of patients (10.2% of hemispheres).
  • Previous ischemic events within 3 months were associated with MES presence (OR 4.41).
  • MESs independently predicted new ischemic stroke and TIA (HR 6.84) and ischemic stroke alone (HR 10.61) during follow-up.

Conclusions:

  • The presence of MESs in moyamoya disease is linked to recent ischemic symptoms.
  • MES detection serves as an independent predictor of future cerebral ischemic events.
  • MES monitoring shows potential clinical utility in managing moyamoya disease patients.
Keywords:
cerebral embolismmicroembolic signalsmoyamoya diseasestroketranscranial Doppler

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