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(Stroke. 1995;26:1588-1592.)
© 1995 American Heart Association, Inc.

Articles

Transcranial Doppler–Detected Microemboli in Patients With Acute Stroke

David C. Tong, MD Gregory W. Albers, MD

From the Stanford Stroke Center, Department of Neurology and Neurologic Sciences, Stanford University Medical Center, Palo Alto, Calif.

Correspondence to David C. Tong, MD, Stanford Stroke Center, 701 Welch Rd, Palo Alto, CA 94304. E-mail dct@leland.stanford.edu.

Background and Purpose Transcranial Doppler sonography (TCD) has been used to detect microembolic signals in a variety of clinical situations. We studied the prevalence of TCD-detected microemboli in 38 acute stroke patients.

Methods Consecutive patients with acute anterior circulation stroke were stratified into high-risk (group 1), medium-risk (group 2), and low-risk (group 3) groups based on their risk factors for cerebral embolism.

Results Microemboli were detected in 11% of patients. They were present in 17% of group 1, 10% of group 2, and 0% of group 3 patients. Emboli were present in patients with mechanical prosthetic valves, carotid stenosis (>70%), and mitral valve strands with a patent foramen ovale. Patients with microemboli more frequently had a history of cerebral ischemia compared with patients without microemboli (P<.05). They also more frequently had recent (<3 months) symptoms compared with patients without microemboli (P<.05). In patients with a cardiac source of embolization, the number of microemboli detected was directly proportional to the acuity of previous symptoms.

Conclusions These data suggest that TCD-detected microemboli are associated with an increased prevalence of prior cerebrovascular ischemia. The presence of TCD-detected microemboli could be a risk factor for cerebrovascular ischemia.

Key Words: embolism • risk factors • signal interpretation, computer-assisted • ultrasonics

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