Stroke, Vol 23, 420-422, Copyright © 1992 by American Heart Association
M Yasaka, T Omae, T Tsuchiya and T Yamaguchi
PURPOSE: We performed the present study to determine whether the site of
cardioembolic occlusion in the carotid axis could be identified by
end-diastolic velocity measurements of the common carotid arteries. SUMMARY
OF REPORT: Using duplex carotid ultrasonography, we measured the flow
velocity in the common carotid arteries and calculated the side-to-side
ratios of the end-diastolic velocity (ED ratio; the end- diastolic velocity
of the nonaffected side divided by that of the affected side) in 46
patients with acute cardioembolic stroke. The velocity on the faster side
was divided by the slower velocity to obtain the normal values of ED ratio
in 30 controls. The ED ratios were compared with the angiographic findings,
in which unilateral intracranial internal carotid artery occlusion was
present in 20 patients (IC group), occlusion of the horizontal segment of
the middle cerebral artery was present in 16 patients (M1 group), and
branch occlusion of the middle cerebral artery was present in 10 patients
(MBr group). The ED ratios of the control group were less than 1.3; those
of the MBr group generally less than 1.3; the IC group greater than 4.0,
except in two patients with severe cerebral edema; and those of the M1
group between 1.3 and 4.0. Therefore, the IC group was easily distinguished
from the other groups by an ED ratio greater than or equal to 4.0, with an
accuracy of 97%, and the M1 group by an ED ratio greater than or equal to
1.3 and less than 4.0, with an accuracy of 93%. CONCLUSIONS: We found the
ED ratio useful to identify internal carotid artery and middle cerebral
artery occlusion in patients with cardioembolic stroke unless severe
cerebral edema was present.
ARTICLES
Ultrasonic evaluation of the site of carotid axis occlusion in patients with acute cardioembolic stroke
Department of Medicine, National Cardiovascular Center, Osaka, Japan.
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