Revue neurologique · 2004
[Pulsed transcranial Doppler examination in the acute phase of stroke].
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de Bray J-M, Tranquart F, Dubas F
Аннотация
INTRODUCTION: Transcranial pulsed Doppler sonography with or without imagery is used in the acute phase of ischemic stroke in order to define stroke mechanism and intracranial hemodynamic consequences.
STATE OF ART: This non-invasive low-cost investigation can be undertaken rapidly, within 10 minutes if guided by focal symptomatology. It detects middle cerebral artery stenosis in >or=50 p. cent of cases with a sensitivity between 75 and 90 p. cent, comparatively with conventional angiography, and middle cerebral artery occlusion with 90 p. cent sensitivity. When a temporal acoustic window is lacking, intravenous injection of a contrast agent allows good visualization of the intracranial vessels and the circle of Willis, in two-third of cases. Moreover, transcranial Doppler data have good prognostic value and facilitate analysis of recanalization after thrombolytic therapy.
CONCLUSION: Beside its diagnostic and prognostic interest, transcranial Doppler sonography using a 2 MHz frequency appears to have therapeutic impact by favoring the thrombolysis process. Future developments may include early and prolonged insonation of patients suffering from stroke.
STATE OF ART: This non-invasive low-cost investigation can be undertaken rapidly, within 10 minutes if guided by focal symptomatology. It detects middle cerebral artery stenosis in >or=50 p. cent of cases with a sensitivity between 75 and 90 p. cent, comparatively with conventional angiography, and middle cerebral artery occlusion with 90 p. cent sensitivity. When a temporal acoustic window is lacking, intravenous injection of a contrast agent allows good visualization of the intracranial vessels and the circle of Willis, in two-third of cases. Moreover, transcranial Doppler data have good prognostic value and facilitate analysis of recanalization after thrombolytic therapy.
CONCLUSION: Beside its diagnostic and prognostic interest, transcranial Doppler sonography using a 2 MHz frequency appears to have therapeutic impact by favoring the thrombolysis process. Future developments may include early and prolonged insonation of patients suffering from stroke.