(Stroke. 2000;31:714.)
© 2000 American Heart Association, Inc.
Original Contributions |
Relationship Between Pattern of Intracranial Artery Abnormalities on Transcranial Doppler and Oxfordshire Community Stroke Project Clinical Classification of Ischemic Stroke
From the Neurosciences Trials Unit, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
Correspondence to Gillian E. Mead, MD, Neurosciences Trials Unit, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK. E-mail GEM{at}skull.dcn.ed.ac.uk
Background and Purpose—The Oxfordshire Community Stroke Project (OCSP) devised a simple classification for acute stroke based on clinical features only, which is of value in predicting prognosis. We investigated whether the pattern of intracranial vascular abnormalities is related to the clinical syndrome.
Methods—Patients with acute ischemic stroke were classified by a stroke physician as having total or partial anterior circulation infarct (TACI or PACI, respectively), lacunar infarct (LACI), or posterior circulation infarct (POCI). Color-coded power transcranial Doppler was done whenever possible. Intracranial arterial velocities were compared in the 4 subtypes of ischemic stroke after adjustment for age and time to transcranial Doppler.
Results—Middle cerebral artery velocity was abnormal (hyperemia, reduced velocity, occlusion, or focal stenosis) in 38 of 69 TACIs (55%), 50 of 171 PACIs (29%), and 20 of 236 LACIs or POCIs (8%) (P<0.001). Velocity in the A1 segment of the anterior cerebral artery was reversed in 12 of 69 TACIs (17%), 20 of 171 PACIs (12%), and 8 of 236 LACIs or POCIs (3%) (P<0.001). Basilar artery velocity was abnormal in 8 of 121 POCIs (7%) compared with 5 of 355 (1%) of the other subtypes (P=0.005). Vertebral artery velocity was abnormal (reduced velocity, occlusion, stenosis) in 20 of 121 POCIs (17%) compared with 20 of 355 others (6%) (P=0.01).
Conclusions—Intracranial arterial abnormalities were related to OCSP clinical subtype. Therefore, it is possible to stratify patients according to OCSP classification in trials of new treatments in which treatment effectiveness may depend on the underlying pattern of arterial pathology and before any arterial imaging is available.
Key Words: cerebrovascular disorders • cohort studies • stroke, acute • ultrasonography, Doppler
This article has been cited by other articles:
 |
|
 |
|
  G E Mead, J M Wardlaw, S C Lewis, M S Dennis, and for the Lothian Stroke Registry Study Group No evidence that severity of stroke in internal carotid occlusion is related to collateral arteries J. Neurol. Neurosurg. Psychiatry, June 1, 2006; 77(6): 729 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. O.C. Corbin, V. Poddar, A. Hennis, A. Gaskin, C. Rambarat, R. Wilks, C. D.A. Wolfe, and H. S. Fraser Incidence and Case Fatality Rates of First-Ever Stroke in a Black Caribbean Population: The Barbados Register of Strokes Stroke, June 1, 2004; 35(6): 1254 - 1258. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Harbison, G. J. Gibson, D. Birchall, I. Zammit-Maempel, and G. A. Ford White matter disease and sleep-disordered breathing after acute stroke Neurology, October 14, 2003; 61(7): 959 - 963. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Harbison, G.A. Ford, O.F.W. James, and G.J. Gibson Sleep-disordered breathing following acute stroke QJM, November 1, 2002; 95(11): 741 - 747. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Sturm, H. M. Dewey, G. A. Donnan, R. A.L. Macdonell, J. J. McNeil, and A. G. Thrift Handicap After Stroke: How Does It Relate to Disability, Perception of Recovery, and Stroke Subtype?: The North East Melbourne Stroke Incidence Study (NEMESIS) Stroke, March 1, 2002; 33(3): 762 - 768. [Abstract] [Full Text] [PDF]
|
|