Intracranial blood flow velocities in acute ischemic stroke

Andrei Alexandrov, Christopher F. Bladin, John W. Norris

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Background and PurposeTranscranial Doppler sonography (TCD) can evaluate noninvasively the blood flow velocities and patency of the main trunk of the middle cerebral artery (MCA). Using TCD we evaluated MCA patency and patterns of flow through the circle of Willis in patients with acute stroke. MethodsPatients with symptoms of hemispheric stroke were evaluated with serial TCD tests during admission. The Canadian Neurological Scale was used to assess neurological deficits. In all cases computed tomographic scan, Tc hexa-methylpropyleneamine oxime single-photon emission computed tomography, and carotid duplex were performed, and in some cases cerebral angiography.Results Seventy-five consecutive patients with symptoms of acute ischemic stroke (mean time, 8±4 hours) were studied. Four circle of Willis perfusion patterns were observed:normal, collateral, stenotic, and occlusive. MCA occlusion or stenosis was seen in 70% of initial TCD studies in the stroke group (n=50) but not in patients with transient ischemic attacks (n = 25). Eighty-six percent of the initial MCA occlusions had recanalized by 2 weeks after onset. Four patients, evaluated within the first 4 hours after onset, illustrated different patterns of MCA flow. TCD findings were compared with cerebral angiography, computed tomography, and single-photon emission computed tomography. Conclusions TCD allows early differentiation of patency and natural history of MCA thromboembolic events. This may have important implications in the decision for thrombolytic therapy.

Original languageEnglish (US)
Pages (from-to)1378-1383
Number of pages6
JournalStroke
Volume25
Issue number7
DOIs
StatePublished - Jan 1 1994

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Blood Flow Velocity
Middle Cerebral Artery
Stroke
Circle of Willis
Cerebral Angiography
Middle Cerebral Artery Infarction
Doppler Ultrasonography
Oximes
Thrombolytic Therapy
Transient Ischemic Attack
Single-Photon Emission-Computed Tomography
Natural History
Pathologic Constriction
Perfusion

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Intracranial blood flow velocities in acute ischemic stroke. / Alexandrov, Andrei; Bladin, Christopher F.; Norris, John W.

In: Stroke, Vol. 25, No. 7, 01.01.1994, p. 1378-1383.

Research output: Contribution to journalArticle

Alexandrov, Andrei ; Bladin, Christopher F. ; Norris, John W. / Intracranial blood flow velocities in acute ischemic stroke. In: Stroke. 1994 ; Vol. 25, No. 7. pp. 1378-1383.
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