Study of Carotid doppler in Patients with ischemic stroke

Abstract

Introduction: Stroke is one of the major causes of increased morbidity and death. Large-vessel atherosclerosis of intracranial and extra cranial carotid vessels is an important cause of ischemic stroke. This research was undertaken to study the carotid Doppler findings in patients with acute ischemic stroke. Methods: A hospital-based prospective cross-sectional study was conducted from January 2020 till December 2020 in the department of Radio diagnosis and Imaging at Manipal Teaching Hospital, Pokhara, Nepal. Neuro-imaging and carotid Doppler findings in patients with ischemic stroke were studied. Data analysis was done using SPSS 20. Results: The mean age of subjects with ischemic stroke was 64 ± 13.4 years with the majority of cases in the age group of 51-70 years of age with male predominance (M: F= 3: 2). Lacunar infarcts (34.2%) were the most common findings followed by MCA infarct (30%) and ACA infarct (10.8%). Carotid plaques were seen in 43.3% patients. Bilateral ICA atheromatous plaque was seen in 48.1% of patients. Carotid bulb was the common site for plaque formation. Type III plaque was the commonest type. Significant ICA stenosis > 50 % was observed in 24.2% patients. Age >50 years, male sex, smoking, hypertension, diabetes, and hyperlipidemia were important risk factors. Conclusion: Carotid artery Doppler demonstrated atherosclerotic plaques and significant stenosis in patients with ischemic stroke. Increasing age >50 years, male sex, smoking, hypertension, diabetes, and hyperlipidemia were associated with an increased rate of atherosclerosis, carotid stenosis and ischemic stroke.

Study the carotid Doppler and computed tomography of head in ischemic stroke patients

“…Out of them, 17 (54.83%) had carotid stenosis >50%. These above clinical profiles were similar to findings from previous studies done by Gyawali et al, 3 Bollipo et al, 11 Fernandes et al, 15 and Pathak et al 16 In the risk factor evaluation in this study, 68 (54.4%) were hypertensive patients, out of whom 48 (70.58%) had significant stenosis. Fernandes et al, 15…”

“…Seventy-five percent of patients with <50% stenosis had lacunar infarcts in CT findings. According to the Rajesh study, 13 Lacunar infarct 41 (34.2%) was the most common CT brain findings, and PCA infarct 12 (10%) was the least common CT finding in ischemic stroke patients, in a study done by Gyawali et al 3 The above study's findings were correlated with our findings.…”

“…12 In a study done by Gyawali et al in the Nepali population, the prevalence of <50% carotid stenosis in stroke patients was 48 (62.3%), ischemic patients who had carotid artery >50-70% stenosis were 18 (23.4%), and carotid artery stenosis >70% patients were 11 (14.3%), which was almost similar findings with our study. 3 However, higher the incidence of ischemic stroke was 46.9% in 50-69% carotid stenosis and only 25% in <50% carotid stenosis in the study done by Rajesh and Richa. 13 Some of the above studies were correlated with our findings, and a few studies did not agree, so there might be a few other risk factors contributing to the development of the ischemic stroke.…”

“…The risk factors for stroke are a previous ischemic attack, a history of diabetes, hypertension, dyslipidemia, the presence of asymptomatic carotid plaques, and a high degree of carotid stenosis. 3 There are many investigations to confirm the diagnosis of stroke, among which computed tomography (CT) and magnetic resonance imaging (MRI) play major roles. 4 Plain CT remains the standard tool for initial assessment in most centers because the large thrombolysis trials were all CT based.…”