Abstract
Background and purpose
Changes of the flow velocities of transcranial color coded duplex ultrasound (TCCD) in symptomatic middle cerebral artery (MCA) occlusive disease may be related to the occurrence of further vascular events after stroke. The objective of this study was to investigate the outcome and the prognosis of the MCA occlusive disease.
Methods
Initial TCCD was done to detect MCA stenosis or occlusion in patients with MCA territory infarction. We repeated TCCD examinations 3 months later and recorded any TIA, cerebral stroke or acute coronary syndrome events during this period. The changes of MCA flow velocities were categorized as normalized, regressive, persistent and progressive groups, according to the changes of MCA velocities at 3 months.
Results
We studied 31 patients with MCA territory infarction classified according to the initial TCCD results into normal MCA flow velocity group (15 patients), and abnormal MCA flow velocity group (16 patients). Eleven patients of the abnormal MCA group were re-evaluated by TCCD after 3 months as 5 patients died within the 3 months of the follow up. Two patients (18.2%) were normalized, 4 patients (36.4%) had persistent degree of stenosis, and 5 patients (45.5%) showed regression. The number of clinical events showed significant difference (p=0.037) between the normal and abnormal MCA groups. Only 1 patient (6.7%) of the normal MCA group had further cerebral stroke, while 7 patients (43.8%) of the abnormal MCA group suffered of further cerebral stroke.
Conclusions
Symptomatic MCA stenosis is associated with higher risk of recurrent cerebral stroke.