International Medical Journal, Vol. 20., Iss. 1, 2014, P. 93−96.
НEMODYNAMIC PATTERNS OF ACUTE PERIOD HEMISPHERIC ISCHEMIC STROKE ACCORDING TO TRANSCRANIAL TRIPLEX SCANNING
Kharkiv Medical Academy of Postgraduate Education
At present ischemic stroke accounts for the majority (80%) of cases of acute cerebrovascular accidents, therefore the search for possibilities of early non−invasive diagnosis of ischemic stroke remains relevant. The purpose of our research was to develop hemodynamic patterns during acute hemispheric ischemic stroke (the first day of the disease) using transcranial triplex scanning of Willis artery. Complex Doppler ultrasonography of the brain vessels was done in 197 patients (134 with ischemic stroke and 64 with transitory ischemic attack). The following hemodynamic parameters were studied: peak systolic blood flow velocity (PSBFV), diastolic blood flow velocity (DBFV), peripheral resistance index (RI), pulsatility index (PI), time−averaged maximum flow velocity (TAMV), cerebral hemispheric asymmetry coefficient (CАs). It was noted that acute hemispheric ischemic stroke can occur with decreased, normal and elevated PSBFV on the side of the stroke. There variants of hemodynamic indices (patterns) were distinguished for these patients. Group 1 showed a significant decline in velocity indices: PSBFV −− 50.7 ±2.7 сm/s; PDBFV −− 15.8 ±1.2 cm/s; TAMV −− 26.4 ±2.7 cm/s; increased peripheral resistance: PI −− 1.39 ±0.06; RI −− 0.71 ±0.04; KAs −− 0.56−0.58. In group 2 velocity indices in the middle cerebral artery on the side of the stroke remained almost unchanged: PSBFV −− 98.8±4.1сm/s; PDBFV −− 29.0±2.4 сm/s; TAMV −− 52. 2±3.5 сm/s. Peripheral resistance indices deviated from the norm and showed increase: PI −− 1.34±0.07; RI −− 0.71±0.04; KAs was close to 1. In group 3 velocity indices and those of peripheral resistance were significantly higher than normal ones: PSBFV −− 146.4±2.9 сm/s; PDBFV −− 23.3±1.9 cm/s; TAMV −− 81.8±3.5 сm/s; PI −− 1.51±0.13; RI −− 0.84±0.04; KAs was between 1.42−1.51. Triplex scanning demonstrated significant reduction in the signal on the side of the stroke in 68 cases (76%), which was consistent with the literature data. Our findings allowed to work out hemodynamic patterns for acute hemispheric ischemic stroke in the acute phase which can be used in practical neurology.
Key words: transcranial triplex scanning, ischemic stroke, hemodynamic patterns.