engleski

Role of transcranial doppler in assessment of stroke outcome

TCD is a noninvasive, painless, bedside method for real time assessment of intracranial criculation. Can TCD values measured at stroke onset be predictive of stroke outcome at patient discharge? Aim of study was to assess TCD values obtained at stroke onset in prediction of stroke outcome measured by Barthel Index (BI) and Rankin scale (RS). We examined 101 stroke patient during a 6 month period. All patients were examined using TCD technique. Mean blood flow velocities (MBFV) were measured in carotid siphon, medial cerebral artery, anterior cerebral artery, posterior cerebral artery of both right and left hemisphere, right vertebral artery, left vertebral artery and basilar artery. Barthel Index was assessed after stroke onset and before patient demission. Rankin scale was assessed before patient demission. There were 101 stroke patients, 53 men and 48 women. Seventy-three patients had ischaemic stroke, 13 patients had haemorrhagic stroke, 4 had subarachnoid haemorrhage and 11 had transitory ischemic attacks. Mean age was 72 years. Thirty-six patients had a complete TCD report, 40 patients had values reported from one side of Willis’ circle, and 54 patients had all values of vertebrobasilar system. For remaining patients all values were not obtained due to technical difficulties. Eighty-five percent of patients had a first ever stroke, and 15% had a recurrent stroke. At admission average BI was 92.83. Before discharge average BI was 64.3 RS before demission showed the following: no symptoms 7%, independent 28%, light disability 9%, moderate disability 9%, moderate to severe disability 23%, severe disability 18%, death 5%. Sixty percent of patients were discharged home, 10% to another institution, 20% went to a rehabilitation center, and 11% were transferred to another ward. Even though TCD is an extremly valuable method in assessment of cerebral blood flow we were not able to predict patient stroke outcome by assessment of TCD values at stroke onset.

transcranial doppler; stroke

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