Circulating Microemboli in 33 Patients with Intracranial Arterial Stenosis
Background: Intracranial arterial stenosis is a rare cause of stroke in Caucasians. Detection of clinically silent circulating microemboli by transcranial Doppler sonography is now widely investigated in patients with carotid artery disease in the hope to identify patients at increased risk for stro...
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| Veröffentlicht in: | Cerebrovascular diseases (Basel, Switzerland) Switzerland), 2002-01, Vol.13 (1), p.26-30 |
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| container_title | Cerebrovascular diseases (Basel, Switzerland) |
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| creator | Droste, Dirk W. Junker, Katja Hansberg, Tjark Dittrich, Ralf Ritter, Martin Ringelstein, E. Bernd |
| description | Background: Intracranial arterial stenosis is a rare cause of stroke in Caucasians. Detection of clinically silent circulating microemboli by transcranial Doppler sonography is now widely investigated in patients with carotid artery disease in the hope to identify patients at increased risk for stroke. Methods: In 33 patients with intracranial internal carotid (n = 12), middle cerebral (n = 18), posterior cerebral (n = 2), or basilar artery stenosis (n = 1), we performed a 1-hour microembolus detection downstream to the stenosis in the middle or in the posterior cerebral artery, respectively. The stenosis was assessed by transcranial Doppler and duplex ultrasound. 18 patients had been symptomatic in the dependent territory. Results: Five patients with ischaemic symptoms within the last 8 days and with a peak systolic flow velocity of ≧210 cm/s in the stenosis showed microembolic signals at a rate of 3–25 events/h, despite effective anticoagulation. All these 5 patients had a lesion pattern on cranial CT or MRI scan suggesting embolic origin. All the asymptomatic patients (n = 15) and all the patients with a peak systolic intrastenostic velocity of 160 to |
| doi_str_mv | 10.1159/000047742 |
| format | Article |
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Bernd</creator><creatorcontrib>Droste, Dirk W. ; Junker, Katja ; Hansberg, Tjark ; Dittrich, Ralf ; Ritter, Martin ; Ringelstein, E. Bernd</creatorcontrib><description>Background: Intracranial arterial stenosis is a rare cause of stroke in Caucasians. Detection of clinically silent circulating microemboli by transcranial Doppler sonography is now widely investigated in patients with carotid artery disease in the hope to identify patients at increased risk for stroke. Methods: In 33 patients with intracranial internal carotid (n = 12), middle cerebral (n = 18), posterior cerebral (n = 2), or basilar artery stenosis (n = 1), we performed a 1-hour microembolus detection downstream to the stenosis in the middle or in the posterior cerebral artery, respectively. The stenosis was assessed by transcranial Doppler and duplex ultrasound. 18 patients had been symptomatic in the dependent territory. Results: Five patients with ischaemic symptoms within the last 8 days and with a peak systolic flow velocity of ≧210 cm/s in the stenosis showed microembolic signals at a rate of 3–25 events/h, despite effective anticoagulation. All these 5 patients had a lesion pattern on cranial CT or MRI scan suggesting embolic origin. All the asymptomatic patients (n = 15) and all the patients with a peak systolic intrastenostic velocity of 160 to <210 cm/s (n = 13) did not show microembolic signals at all. Conclusion: Microembolic signals occur in recently symptomatic patients with high-grade intracranial arterial stenosis indicated by a sonographically measured stenotic peak flow velocity of ≧210 cm/s. Therapeutic anticoagulation was not sufficient to suppress microemboli formation.</description><identifier>ISSN: 1015-9770</identifier><identifier>EISSN: 1421-9786</identifier><identifier>DOI: 10.1159/000047742</identifier><identifier>PMID: 11810007</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Blood Flow Velocity ; Brain Infarction - diagnosis ; Brain Infarction - epidemiology ; Cerebrovascular Circulation ; Female ; Humans ; Intracranial Arterial Diseases - diagnostic imaging ; Intracranial Arterial Diseases - epidemiology ; Intracranial Embolism - diagnostic imaging ; Intracranial Embolism - epidemiology ; Male ; Middle Aged ; Original Paper ; Risk Factors ; Ultrasonography, Doppler, Duplex ; Ultrasonography, Doppler, Transcranial</subject><ispartof>Cerebrovascular diseases (Basel, Switzerland), 2002-01, Vol.13 (1), p.26-30</ispartof><rights>2002 S. Karger AG, Basel</rights><rights>Copyright 2002 S. Karger AG, Basel</rights><rights>Copyright (c) 2002 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c355t-e658cab5dab3221d63268f998235a1009e6f0df2a8c6d1ed1530f79edfde9aa93</citedby><cites>FETCH-LOGICAL-c355t-e658cab5dab3221d63268f998235a1009e6f0df2a8c6d1ed1530f79edfde9aa93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11810007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Droste, Dirk W.</creatorcontrib><creatorcontrib>Junker, Katja</creatorcontrib><creatorcontrib>Hansberg, Tjark</creatorcontrib><creatorcontrib>Dittrich, Ralf</creatorcontrib><creatorcontrib>Ritter, Martin</creatorcontrib><creatorcontrib>Ringelstein, E. Bernd</creatorcontrib><title>Circulating Microemboli in 33 Patients with Intracranial Arterial Stenosis</title><title>Cerebrovascular diseases (Basel, Switzerland)</title><addtitle>Cerebrovasc Dis</addtitle><description>Background: Intracranial arterial stenosis is a rare cause of stroke in Caucasians. Detection of clinically silent circulating microemboli by transcranial Doppler sonography is now widely investigated in patients with carotid artery disease in the hope to identify patients at increased risk for stroke. Methods: In 33 patients with intracranial internal carotid (n = 12), middle cerebral (n = 18), posterior cerebral (n = 2), or basilar artery stenosis (n = 1), we performed a 1-hour microembolus detection downstream to the stenosis in the middle or in the posterior cerebral artery, respectively. The stenosis was assessed by transcranial Doppler and duplex ultrasound. 18 patients had been symptomatic in the dependent territory. Results: Five patients with ischaemic symptoms within the last 8 days and with a peak systolic flow velocity of ≧210 cm/s in the stenosis showed microembolic signals at a rate of 3–25 events/h, despite effective anticoagulation. All these 5 patients had a lesion pattern on cranial CT or MRI scan suggesting embolic origin. All the asymptomatic patients (n = 15) and all the patients with a peak systolic intrastenostic velocity of 160 to <210 cm/s (n = 13) did not show microembolic signals at all. Conclusion: Microembolic signals occur in recently symptomatic patients with high-grade intracranial arterial stenosis indicated by a sonographically measured stenotic peak flow velocity of ≧210 cm/s. Therapeutic anticoagulation was not sufficient to suppress microemboli formation.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Flow Velocity</subject><subject>Brain Infarction - diagnosis</subject><subject>Brain Infarction - epidemiology</subject><subject>Cerebrovascular Circulation</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Arterial Diseases - diagnostic imaging</subject><subject>Intracranial Arterial Diseases - epidemiology</subject><subject>Intracranial Embolism - diagnostic imaging</subject><subject>Intracranial Embolism - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Risk Factors</subject><subject>Ultrasonography, Doppler, Duplex</subject><subject>Ultrasonography, Doppler, Transcranial</subject><issn>1015-9770</issn><issn>1421-9786</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNptkEtLAzEUhYMotlYXrgUZXAguRnMn88qyjFUrFQV1PWQmd2rqPGqSQfz3prZYELO5J-TjnJtDyDHQS4CIX1F3wiQJgx0yhDAAnydpvOs0hcjphA7IgTELR8WQwj4ZgBvulgzJfaZ02dfCqnbuPahSd9gUXa081XqMeU_uAVtrvE9l37xpa7UotWiVqL2xtqhX4tli2xllDsleJWqDR5s5Iq83k5fszp893k6z8cwvWRRZH-MoLUURSVGwIAAZsyBOK87TgEXCbcUxrqisApGWsQSUEDFaJRxlJZELwdmInK99l7r76NHYvFGmxLoWLXa9yRMIIUw5OPDsD7joet263XIXDGFMOXXQxRpyXzdGY5UvtWqE_sqB5qt28992HXu6MeyLBuWW3NS5TXwXeo76F8gm1z8O-VJWDjr5F1pnfAM8YYfk</recordid><startdate>200201</startdate><enddate>200201</enddate><creator>Droste, Dirk W.</creator><creator>Junker, Katja</creator><creator>Hansberg, Tjark</creator><creator>Dittrich, Ralf</creator><creator>Ritter, Martin</creator><creator>Ringelstein, E. Bernd</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200201</creationdate><title>Circulating Microemboli in 33 Patients with Intracranial Arterial Stenosis</title><author>Droste, Dirk W. ; Junker, Katja ; Hansberg, Tjark ; Dittrich, Ralf ; Ritter, Martin ; Ringelstein, E. Bernd</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c355t-e658cab5dab3221d63268f998235a1009e6f0df2a8c6d1ed1530f79edfde9aa93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Flow Velocity</topic><topic>Brain Infarction - diagnosis</topic><topic>Brain Infarction - epidemiology</topic><topic>Cerebrovascular Circulation</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Arterial Diseases - diagnostic imaging</topic><topic>Intracranial Arterial Diseases - epidemiology</topic><topic>Intracranial Embolism - diagnostic imaging</topic><topic>Intracranial Embolism - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Risk Factors</topic><topic>Ultrasonography, Doppler, Duplex</topic><topic>Ultrasonography, Doppler, Transcranial</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Droste, Dirk W.</creatorcontrib><creatorcontrib>Junker, Katja</creatorcontrib><creatorcontrib>Hansberg, Tjark</creatorcontrib><creatorcontrib>Dittrich, Ralf</creatorcontrib><creatorcontrib>Ritter, Martin</creatorcontrib><creatorcontrib>Ringelstein, E. Bernd</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Cerebrovascular diseases (Basel, Switzerland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Droste, Dirk W.</au><au>Junker, Katja</au><au>Hansberg, Tjark</au><au>Dittrich, Ralf</au><au>Ritter, Martin</au><au>Ringelstein, E. Bernd</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Circulating Microemboli in 33 Patients with Intracranial Arterial Stenosis</atitle><jtitle>Cerebrovascular diseases (Basel, Switzerland)</jtitle><addtitle>Cerebrovasc Dis</addtitle><date>2002-01</date><risdate>2002</risdate><volume>13</volume><issue>1</issue><spage>26</spage><epage>30</epage><pages>26-30</pages><issn>1015-9770</issn><eissn>1421-9786</eissn><abstract>Background: Intracranial arterial stenosis is a rare cause of stroke in Caucasians. Detection of clinically silent circulating microemboli by transcranial Doppler sonography is now widely investigated in patients with carotid artery disease in the hope to identify patients at increased risk for stroke. Methods: In 33 patients with intracranial internal carotid (n = 12), middle cerebral (n = 18), posterior cerebral (n = 2), or basilar artery stenosis (n = 1), we performed a 1-hour microembolus detection downstream to the stenosis in the middle or in the posterior cerebral artery, respectively. The stenosis was assessed by transcranial Doppler and duplex ultrasound. 18 patients had been symptomatic in the dependent territory. Results: Five patients with ischaemic symptoms within the last 8 days and with a peak systolic flow velocity of ≧210 cm/s in the stenosis showed microembolic signals at a rate of 3–25 events/h, despite effective anticoagulation. All these 5 patients had a lesion pattern on cranial CT or MRI scan suggesting embolic origin. All the asymptomatic patients (n = 15) and all the patients with a peak systolic intrastenostic velocity of 160 to <210 cm/s (n = 13) did not show microembolic signals at all. Conclusion: Microembolic signals occur in recently symptomatic patients with high-grade intracranial arterial stenosis indicated by a sonographically measured stenotic peak flow velocity of ≧210 cm/s. Therapeutic anticoagulation was not sufficient to suppress microemboli formation.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>11810007</pmid><doi>10.1159/000047742</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Blood Flow Velocity Brain Infarction - diagnosis Brain Infarction - epidemiology Cerebrovascular Circulation Female Humans Intracranial Arterial Diseases - diagnostic imaging Intracranial Arterial Diseases - epidemiology Intracranial Embolism - diagnostic imaging Intracranial Embolism - epidemiology Male Middle Aged Original Paper Risk Factors Ultrasonography, Doppler, Duplex Ultrasonography, Doppler, Transcranial |
| title | Circulating Microemboli in 33 Patients with Intracranial Arterial Stenosis |
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