Spontaneous Middle Cerebral Artery Reperfusion in Ischemic Stroke

Abstract

TCD examination offers an easy and reliable way of monitoring MCA reopening and might be useful to identify subgroups of patients who may benefit most from pharmacological reperfusion.

Relationship Between Pattern of Intracranial Artery Abnormalities on Transcranial Doppler and Oxfordshire Community Stroke Project Clinical Classification of Ischemic Stroke

“…The most common MCA abnormality was reduced ipsilateral MCA velocity, which probably occurred either as a result of major branch or main stem occlusion or during the initial reopening phase of main stem MCA occlusion after embolus migration and hence distal vessel occlusion. 20 The proportion of patients with MCA occlusion was similar to previous studies of MCA infarcts (in which between 33% and 67% had MCA occlusion), although, in these earlier studies, patients had TCD within a few hours of stroke onset. [11][12][13] We found MCA stenosis in a small number of patients, which may be due to primary atherosclerotic stenosis or more likely a recanalizing embolic occlusion.…”

“…8 Abnormally high MCA velocities were also seen, probably as a result of reactive postischemic hyperemia. 20 We found associations between the presence of MCA abnormalities and disease of the ICA at the bifurcation or in the siphon, which would be Data from the vessel ipsilateral to the site of the brain lesion are given. Two POCIs and 1 LACI with bilateral lesions are excluded.…”

Systematic Review of Methods for Assessing Leptomeningeal Collateral Flow

“…5 MR imaging (n ϭ 358 patients) and TCD (n ϭ 268 patients) were used according to 9 and 6 grading methods respectively, with no assessments of interobserver agreement being reported (Tables 4 and 5). 2,13,19,27,31,35,51,[74][75][76][77][78][79][80][81][82][83][84][85][86] A total of 8 publications compared noninvasive LMF assessments with MR imaging (n ϭ 5), CT (n ϭ 2), or TCD (n ϭ 1) with a reference standard by using DSA; in each, a different grading scale for the criterion standard was used. 13,19,27,31,[34][35][36]51 …”

Transcranial Doppler findings in middle cerebral arterial occlusive disease in relation to degree of stenosis and presence of concomitant stenoses

“…Second, many patients had TCD a few days before angiography (and therefore vessel recanalization may have occurred by the time of angiography). 26,27 Atherosclerosis was the most likely cause of stenosis in our patients because we excluded patients with potential cardioembolism (recanalization is more frequent in the latter than in the former), and we also excluded patients in whom recanalization was expected between TCD and angiography based on clinical circumstances. Moreover, the interval between TCD and angiography in the present study was relatively short (mean, 2.5 days).…”