O4-5 Clinical application of mandibular window for TCD monitoring

Our aim is to investigate how many cases we are able to conduct the adequate TCD monitoring in order to estimate the presence of microembolic signals (MES) in stroke patients. We prospectively registered acute stroke patients within 7 days of onset. We insonated TCD transducer from mandibular window. Target vessel was extra-cranial internal carotid artery. We fixed TCD transducer to right mandibular window using stiff headframe. Monitoring duration was 20 min. After we classified patients into two groups, successful monitoring group (SM group) and incomplete monitoring group (IM group), we compared clinical background between SM and IM groups. From June to October 2010, we enrolled 56 acute stroke patients (men; 37, median age; 74 years-old). Stroke subtype is as follows; large artery atherosclerosis (LAA) of 4 cases, small vessel occlusion of 10, and other/unknown cause of 19. We were able to complete the TCD monitoring for 46 (82%) patients as SM group. Two patients who were diagnosed as LAA had MES. Patients with coma and dysphagia were frequently observed in IM group.