(Stroke. 2000;31:543-a.)
© 2000 American Heart Association, Inc.
Letters to the Editor |
Asymptomatic Embolization Predicts Stroke and TIA Risk in Patients With Carotid Artery Stenosis
Medical School, University of Athens, Areteion Hospital, Athens, Greece
Key Words: cerebral embolism • stroke • ultrasonography
To the Editor:
It was very interesting to read in Stroke the article of Molloy et al,1 as well as those of other investigators, concerning embolic signals (ES).2 3 Since we believe that the use of transcranial Doppler (TCD) will contribute to the stratification of the high-risk patients who are candidates for sustaining a stroke, we would like to first congratulate the authors and to add certain observations and knowledge that might prove to be useful in such a future program.
I would like to enlarge upon the following points. (1) The investigation with TCD of patients depicting embolic signals (ES) of 60-minute duration has given an interesting outcome. The results may be more beneficial if the evolution of the method will finally permit its application on a 24-hour basis, similar to the Holter method used in cardiology. (2) The evaluation of the patients under everyday working conditions (hypertension period) might add profitable informative data. (3) Not only the quality but also the quantity of ES might be related to the frequency and gravity of the ensuing cerebral episode. (4) The placing of probes concomitantly on the thoracic wall and along the neck area will also signal the focus of origin of emboli (heart, aortic arch, carotid). (5) The intraoperative application of the method with preoperative and postoperative mapping with MRI of the brain will also proffer an answer for the value of various other technique at the aortic arch and its branches, relative to the presence of ES.
We would
Clinical Neuroscience, St George’s Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK, Telephone: 44-0181-672-9944/E-mail h.markus@sghms.ac.uk