AI Article Synopsis
Article Abstract
Background And Purpose: Transcranial Doppler (TCD) helps identify patients with carotid dissections at risk of ischemic events (IEs). There is paucity of data identifying independent predictors of IE in vertebral arterial dissection (VAD). We sought to investigate the clinical and ultrasound predictors of IE.
Methods: Patients with VAD admitted between June 2017 and February 2020 were evaluated clinically and with TCD; sonographic curves, microembolic signals (MES), and the breath-holding index (BHI) test were applied. Covariates found on univariate screen (P < .25) were included in a multivariable linear regression to identify independent predictors of IEs.
Results: Of 88 patients with 100 VAD, 75 (85.2%) were females with a mean age 37.9 ± 7.5 years. All patients received antiplatelet treatment. TCD monitoring lasted an average of 21 ± 2.1 minutes. TCD was abnormal in 23 cases (26.1%); 21 patients had abnormal sonographic curves in the vertebral/basilar arteries, while in 4 cases, MES were present and in 5 (4.5%), BHI was abnormal. None of the patients with a normal TCD had an IE. Six strokes occurred during follow up. On univariate analysis, male sex, diabetes, dyslipidemia, a previous myocardial infarct, migraine, time of consultation to the ER, bilateral VAD, MES, BHI abnormalities, post stenotic flow in the basilar artery (PFB), and basilar/vertebral velocities were significantly associated with the risk of IEs. In the multivariate analysis, only the presence of PFB was a significant predictor of IE (OR: 68.6, 95% CI 5-937, <.001).
Conclusions: TCD in VAD predicts patients at high risk of IE.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/jon.12773 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hydroxyurea therapy for neurological and cognitive protection in pediatric sickle cell anemia in Uganda (BRAIN SAFE II): Protocol for a single-arm open label trial.
Contemp Clin Trials Commun
December 2024
Department of Pediatrics, Columbia University Irving Medical Center, New York, USA.
Background: Children with sickle cell anemia (SCA) in Sub-Saharan Africa are at high risk of sickle cerebrovascular injury (SCVI). Hydroxyurea, a commonly used disease-modifying therapy, may reduce SCVI resulting in potential impact on reducing stroke and cognitive dysfunction. We aim to test the impact of daily hydroxyurea therapy on these outcomes in Ugandan children with SCA.
View Article and Find Full Text PDFUnravelling the role of carotid atherosclerosis in predicting cardiovascular disease risk: A review.
ARYA Atheroscler
January 2024
General Practitioner, Pertamina Central Hospital, South Jakarta, Indonesia.
Carotid atherosclerosis disease assessment can predict the patient's risk of cardiovascular disease (CVD). The purpose of this review is to provide a comprehensive review of carotid atherosclerosis disease's pathophysiology, diagnostic evaluation, imaging applications, and treatment strategies. Carotid atherosclerosis is diagnosed using a variety of techniques, including transcranial Doppler imaging (TCD), computed tomography angiography (CTA), magnetic resonance angiography (MRA), and cerebral digital subtraction angiography (DSA), with duplex ultrasound (DUS) as the primary screening.
View Article and Find Full Text PDFImpact of transcranial Doppler screening on stroke prevention in children and adolescents with sickle cell disease: A systematic review and meta-analysis.
Blood Rev
December 2024
Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and Medicine, University of Toronto, Ontario, Canada. Electronic address:
Background: Children with sickle cell disease (SCD) have increased stroke risk, identifiable by elevated velocities on transcranial Doppler (TCD). This review assessed the impact of TCD screening on stroke, mortality, quality of life and morbidity in children with SCD.
Methods: A systematic search of MEDLINE, PubMed, Cochrane libraries, and trial registries was conducted from inception to 28th February 2023.
Microembolic signal detection in acute ischemic stroke: Clinical relevance and impact on treatment individualization-A narrative review.
Eur J Neurol
January 2025
Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Background: Microembolic signals (MES) can be detected using transcranial Doppler (TCD) ultrasound in several clinical scenarios, including acute ischemic stroke (AIS). This narrative review aims to provide insights into their role in AIS patient management and outcomes.
Methods: The present narrative review consolidates current observational and randomized evidence on the prevalence and clinical relevance of MES in different AIS subtypes and settings.
Application of high-quality targeted temperature management guided by multimodal brain monitoring in brain protection of patients with cardiac arrest: A case series.
Medicine (Baltimore)
December 2024
Department of Intensive Care Medicine, Xiangya Hospital, Central South University, Changsha, China.
Rationale: Cardiac arrest (CA) is an acute emergency with high mortality and is closely associated with the risk of brain damage or systemic ischemia-reperfusion injury, post-traumatic stress symptoms.
Patient Concerns: Targeted temperature management in the intensive care unit can improve the neurological outcomes of patients who are comatose after resuscitation from CA. However, there is often a lack of specific evaluation methods for optimal target temperature settings.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!