Use of transcranial Doppler ultrasound to predict outcome in patients with intracranial large-artery occlusive disease.

Content Provider	Semantic Scholar
Author	Wong, K. S. Lawrence Li, Huan Chan, Yu Leung Ahuja, Anil Lam, Wynnie Wai-Man Wong, Adrian
Copyright Year	2000
Abstract	BACKGROUND AND PURPOSE Intracranial large-artery occlusive disease is the predominant vascular lesion found in stroke patients of Asian, African, and Hispanic ancestry, making it numerically perhaps the most common vascular cause of stroke in the world. Relatively little is known about the clinical significance of finding such lesions. We investigate whether the presence and the extent of these vascular lesions help predict outcome after stroke. METHODS On the basis of transcranial Doppler of the intracranial arteries with supplementary duplex ultrasound of the carotid arteries, we determined the number of occlusive arteries in the craniocervical circulation of consecutive patients who were hospitalized for acute cerebral ischemia. Patients were followed for 6 months for further vascular events (including transient ischemic attack, stroke, and acute coronary syndrome) or death. RESULTS Among 705 consecutive Chinese patients studied, occlusive arteries were found in 345 patients (49%): 258 patients (37%) had intracranial lesions only, 71 (10%) had both extracranial and intracranial lesions, and 16 (2.3%) had extracranial lesions only. Sixty-three (18%) of the 345 patients with occlusive arteries and 35 (9.7%) of the 360 patients without occlusive arteries had further vascular event or death within 6 months. The risk of vascular events or death increased rapidly with rising numbers of occlusive arteries, after adjustment for vascular risk factors and stroke severity (adjusted odds ratio [OR] 1.25 per occlusive artery, 95% CI 1.12 to 1.39). Other independent risk factors included age (OR 1.03 per year of age, 95% CI 1.01 to 1.05) and atrial fibrillation (OR 3.00, 95% CI 1.40 to 6.69). CONCLUSIONS In patients with predominantly intracranial large-artery occlusive disease, the presence and the total number of occlusive arteries in the craniocervical circulation predict further vascular events or death within 6 months after stroke. Transcranial Doppler ultrasound is an important investigation for the evaluation of patients with stroke in populations at risk of intracranial atherosclerotic disease.
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PubMed reference number	11062288v1
Volume Number	31
Issue Number	11
Journal	Stroke
Language	English
Access Restriction	Open
Subject Keyword	Acute Coronary Syndrome Arterial system Arteries Atrial Fibrillation Carotid Stenosis Cerebral Ischemia Cerebrovascular accident Cessation of life Coronary Artery Disease Forty Nine Heart Atrium High-Risk Pregnancy Intracranial Aneurysm Intracranial Hemorrhages Odds Ratio Parkinson Disease Patients Transient Ischemic Attack Ultrasonography Ultrasonography, Doppler, Duplex Ultrasonography, Doppler, Transcranial Vascular Diseases Volkmann Contracture
Content Type	Text
Resource Type	Article