Background Cerebral stroke is a major source of mortality and morbidity. Duplex ultrasonography is used to evaluate carotid and cerebral arteries. The objectives of this work are to study the correlation between carotid duplex parameters with risk factors of ischemic stroke and evaluate duplex parameter as prognostic tool of ischemic stroke. Methods The study was conducted on 100 patients presented by acute ischemic stroke submitted to history taking, medical, and neurological examination. Neurological deficit was assessed by National Institute of Health Stroke Scale (NIHSS); the functional state of the patients was assessed by modified Rankin scale (mRS). Brain CT and/or MRI, routine laboratory investigations, extracranial, and transcranial duplex (TCD) were done. Results The end diastolic velocities (EDVs) and peak systolic velocities (PSVs) of common carotid arteries (CCA) were significantly decreased in smokers and hypertensive (P<0.05). Smoking and hypertension were positively correlated with resistive index (RI). In 80 patients, PSV in the symptomatic middle cerebral artery (MCA) did not exceed 70 cm/s within averaged 50.7 ± 4.6 cm/s. EDV was 12.0 ± 3.0 cm/s, RI was 0.78 ± 0.05, and pulsativity index (PI) was 1.61 ± 0.09. There was significant difference in all hemodynamic parameters in comparison with the asymptomatic side. Conclusion Patients who have risk factors of stroke should be evaluated with duplex ultrasonography. Duplex parameters can give informative data about prognosis and outcome.

Background The administration of recombinant tissue plasminogen activator (rt-PA) has increased the focus on acute ischemic stroke (AIS) as an emergency condition. The emergency physicians have to rapidly recognize the patients who are candidates for rt-PA and refer them to the specialized stroke team within the proper time window. The knowledge of the emergency physicians about the benefit and the drawbacks of this therapy is crucial and it affects their attitudes towards its use. Objective To apply a survey on the Egyptian emergency physicians aiming to investigate their knowledge about the use rt-PA therapy in AIS. Methodology A self-administered questionnaire was sent to the emergency physicians who are working in three Egyptian governorates. Results Out of 120 emergency physicians, the total knowledge of the study group was good with a score of 7 ± 1.8/11. Most of the participants mentioned the correct answers (over 50%) for all items except for one question regarding the blood glucose control before the use of rt-PA. Significant positive correlation was noted between the knowledge score and the age. Conclusions The surveyed emergency physicians had a good knowledge about the use of rt-PA in AIS, yet, this knowledge is mainly theoretical. Therefore, tutorials, clinical training, and active engagement in the stroke care team are warranted to improve their clinical practice.