Cerebral Ischaemia and Stroke; Role of Carotid Doppler

Abstract

ABSTRACT… Introduction: Colour Doppler sonography is a well-established widely available, noninvasive, cost effective and a reliable method for assessing cerebrovascular circulation. It has become a valuable completion of the sonographic workup in patients with cerebral ischaemia and infarction. Its accuracy is close to angiography. Objectives: To determine the frequency of significant carotid artery stenosis in patients of cerebral ischaemia/stroke and its characterized sonographic appearance of plaque. Study Design: Cross sectional study, based on nonprobability convenience sample technique. Setting: Department of Radiology, Combined Military Hospital Lahore, using Colour and Power Doppler Ultrasound machine ALOKA SSD-5500. Period: 14 October 2006 to 15 March 2007. Methodology: Total of 50 diagnosed patients of either gender, aged 30 to 70 years with cerebral ischaemia and stroke were included in the study. Carotid Doppler examination was conducted in each patient and findings were recorded. Results: Among 50 patients who underwent carotid Doppler examination for diagnosis of clinically significant carotid artery stenosis, 35 patients had carotid plaques. 08 patients were diagnosed to have more than 70 % stenosis, 07 patients with more than 50 % and 20 patients less than 50 % carotid artery stenosis. 15 patients did not show any carotid artery disease. 12 patients had bilateral stenosis while 23 had unilateral disease. Mean age of the patients with and without carotid artery disease was 52 ± 7.87 years. Conclusion: Majority of patients with Cerebral ischemia/stroke showed carotid artery stenosis on colour Doppler ultrasound. Common age group who developed cerebral ischemia/stroke was above 50years.

Study of Carotid doppler in Patients with ischemic stroke

“…It was almost similar 68% in the previous Nepalese study by Pathak et al 8 In our current study, the mean age of subjects with ischemic stroke was 64±13.4 years with majority of cases in age group of 51-70 years of age with male predominance (M:F= 3: 2). The mean age of the patients was 61, 60.5, and 52 years with male dominance in an earlier study by Pathak et al 8 , Syed et al 9 , and Khan et al 10 In the studies by Fernandes et al 11 and Chamarthi et al 12 , the highest incidence of stroke was found in the male population in the age group of 51-70 years; findings consistent to our study. However, maximum number of patients belonged to even younger age group of 51-60 years according to Haq et al1 3 About 7.5% were young stroke patients, aged <40 years in the current study.…”

“…Significant ICA stenoses >50 % was observed in 24.2% patients with ischemic stroke in the current study. Similar (28%) was the finding by Bharathi et al15 It was however, lower (12%) according to Chamarthi et al12 ICA stenoses>50% was observed higher (43% and 45.1%) in the studies by Khan et al10 and Bollipo et al14 respectively. Near total occlusion was seen in 2.5% of the patients while none of the patients had a complete occlusion in the current study.…”

“…Lacunar infarcts were similarly the most common CT findings according to Syed et al 9 and Fernandes et al 11 Doppler sonography diagnosed 43.3% patients to have plaques and stenosis within the carotid vessels. This was even higher; 70%, 78% and 82 % according to Khan et al 10 , Fernandes et al 11 and Bollipo et al 14 Among the patients with atherosclerotic plaque, 69.1%…”

“…patients in the current study. Bilateral plaques were observed in 31.7%, 35% ,46 % and 59 % according to Boliipo et al 14 , Khan et al 10 Chamarthi et al 12 and Fernandes et al 11 respectively.…”

Preoperative Carotid Duplex Scanning in Patients Undergoing Coronary Artery Bypass Grafting

“…Therefore, the comorbidity of coronary and carotid artery disease should be evaluated in detail during the preoperative period. Khan et al [21] reported that color Doppler sonography is nowadays the first imaging examination performed for the diagnosis of carotid artery stenosis. Its dual ability to evaluate both morphologic and hemodynamic abnormalities and its cost-effectiveness make color Doppler ultrasound the only test applied before a therapeutic decision [21] .…”