Department of Neurology, Skåne University Hospital--Malmö, Lund University, Sweden.
Acta Neurol Belg. 2011 Jun;111(2):111-5.
Data concerning the persistent reduction of flow velocities measured by transcranial color-coded sonography (TCCS) in relation to the clinical and radiological outcome among patients with ischemic events in middle cerebral artery (MCA) territory is scarce. Patients with > or = 50% reduction of peak systolic velocities (PSV-MCA) as compared to the contralateral MCA were prospectively included in follow-up by TCCS (mean 404 days). Out of 849 patients with stroke admitted to our stroke unit, 25 patients showed reduced PSV-MCA and included in the analyses of this study. Ten (40%) survivors showed persistent reduction of PSV-MCA. None of the patients with normalized PSV-MCA suffered an ischemic event compared with three patients with persistent reduction of PSV-MCA (all had ipsilateral occlusion of the internal carotid artery caused by dissection). Patients with persistently reduced PSV-MCA exhibited significantly (Mann-Whitney test, p = 0.02) larger infarct volumes on CT (mean +/- SD 38 +/-50 cm3) compared to those with normalized PSV-MCA (6 +/- 7 cm3). The functional outcome were, however, similar in patients with normalized and those with persistently reduced PSV-MCA. We found that a relatively high percentage (40%) of patients suffered ischemic event in the MCA territory with initial reduction of flow velocity on TCCS showed persistent reduction on long term follow-up.
关于经颅彩色编码超声（TCCS）测量的脑中部动脉（MCA）区域缺血性事件患者的血流速度持续降低与临床和影像学结果之间关系的数据较少。将 TCCS 随访中与对侧 MCA 相比 PSV-MCA 减少>或=50%的患者（平均 404 天）前瞻性纳入（PSV-MCA）。在我院卒中单元收治的 849 例卒中患者中，25 例 PSV-MCA 降低，纳入本研究分析。10 例（40%）幸存者 PSV-MCA 持续降低。与持续 PSV-MCA 降低的 3 例患者相比（所有患者均为颈动脉夹层引起的同侧颈内动脉闭塞），无 PSV-MCA 正常化患者发生缺血性事件。与 PSV-MCA 正常化患者相比，PSV-MCA 持续降低患者的 CT 梗死体积明显更大（Mann-Whitney 检验，p = 0.02，平均值 +/- 标准差 38 +/-50 cm3）。然而，PSV-MCA 正常化和 PSV-MCA 持续降低患者的功能预后相似。我们发现，在 TCCS 显示初始血流速度降低的患者中，相当高比例（40%）的 MCA 区域发生缺血性事件，在长期随访中持续降低。
