Telman Gregory, Namestnikov Olga, Kouperberg Efim, Sprecher Elliot, Yarnitsky David
Department of Neurology, Rambam Health Care Campus and Technion Faculty of Medicine, Haifa, Israel.
J Stroke Cerebrovasc Dis. 2008 Nov-Dec;17(6):366-9. doi: 10.1016/j.jstrokecerebrovasdis.2008.04.004.
We investigated the interconnection between natural history of middle cerebral artery (MCA) recanalization by transcranial Doppler (TCD) and stroke severity in patients not treated by fibrinolysis. A total of 54 patients with an acute MCA stroke were examined within the first 24 hours and again within 120 hours after stroke onset. The first TCD examination detected 16 patients (29.6%) with complete occlusion, 27 patients (50%) with partial occlusion, and 11 patients (20.4%) with patent MCA. There were no significant differences among groups according to mean National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale values. The second examination revealed 7 patients (13.2%) with complete occlusion, 31 patients (58.5%) with partial occlusion, and 15 patients (28.3%) with patent MCA. The mean NIHSS score in patients with total occlusion was significantly higher than in patients without occlusion or with partial occlusion. There was no significant difference in mean NIHSS value between patients with and without improvement on the second TCD examination. We conclude that MCA occlusion by TCD is associated with more severe stroke than that of patients without occlusion or with only a partial occlusion. A later MCA recanalization is not accompanied by significant improvement of neurologic or functional status.
我们研究了未接受纤维蛋白溶解治疗的患者中，经颅多普勒（TCD）检测到的大脑中动脉（MCA）再通自然史与中风严重程度之间的相互关系。共有54例急性MCA中风患者在发病后24小时内接受了检查，并在发病后120小时内再次接受检查。首次TCD检查发现16例（29.6%）患者MCA完全闭塞，27例（50%）患者部分闭塞，11例（20.4%）患者MCA通畅。根据美国国立卫生研究院卒中量表（NIHSS）和改良Rankin量表值，各组之间无显著差异。第二次检查发现7例（13.2%）患者MCA完全闭塞，31例（58.5%）患者部分闭塞，15例（28.3%）患者MCA通畅。完全闭塞患者的平均NIHSS评分显著高于未闭塞或部分闭塞患者。第二次TCD检查有改善和无改善的患者之间，平均NIHSS值无显著差异。我们得出结论，与未闭塞或仅部分闭塞的患者相比TCD检测到的MCA闭塞与更严重的中风相关。MCA后期再通并未伴随神经或功能状态的显著改善。
