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Related Concept Videos

Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...

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Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
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Clinical Risk Factors for Stroke and Associations with Microembolic Signals on Transcranial Doppler.

Abdullah A Adil1, Carol C Mitchell2, Thomas D Cook3

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Michigan.

Journal for Vascular Ultrasound : JVU
|August 11, 2025
PubMed
Summary

Microembolic signals (MES) in carotid atherosclerosis (CAS) are linked to older age and male sex. This suggests plaques in both symptomatic and asymptomatic individuals may release microemboli, requiring further research into unstable plaque identification.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Medical Imaging

Background:

  • Carotid atherosclerosis (CAS) poses a significant stroke risk.
  • Microembolic signals (MES), detected via Transcranial Doppler (TCD), are hypothesized to originate from unstable carotid plaques.
  • Understanding the relationship between clinical risk factors for stroke (CRFs) and MES presence is crucial for risk stratification in CAS patients.

Purpose of the Study:

  • To investigate the association between clinical risk factors for stroke (CRFs) and the presence of microembolic signals (MES) in patients with advanced carotid atherosclerosis (CAS).

Main Methods:

  • Prospective evaluation of 89 participants undergoing carotid endarterectomy (CEA) for >60% stenosis.
  • Preoperative assessment of CRFs and detection of MES using Transcranial Doppler (TCD).
  • Statistical analysis including Kendall's tau, Pearson chi-squared, and logistic regression to determine associations between MES and CRFs.

Main Results:

  • Microembolic signals (MES) were detected in 36% of participants.
  • MES showed a significant association with older age (p=0.026) and male sex (p=0.007).
  • Logistic regression identified age, sex, and hyperlipidemia as significant predictors for MES presence (p=0.001).

Conclusions:

  • In advanced carotid atherosclerosis, MES are associated with older age and male sex.
  • Symptomatic status did not predict MES, indicating that plaques in both symptomatic and asymptomatic individuals can release microemboli.
  • Further research is needed to identify specific characteristics of unstable carotid plaques.