Kaps M, Damian M S, Teschendorf U, Dorndorf W
Department of Neurology, Justus-Liebig-Universität Giessen, Federal Republic of Germany.
Stroke. 1990 Apr;21(4):532-7. doi: 10.1161/01.str.21.4.532.
We evaluated the efficacy of transcranial Doppler ultrasonography in 23 patients suffering from acute middle cerebral artery occlusion. The diagnosis of occlusion was most suggestive when all basal arteries except the affected middle cerebral artery were detectable. Enhanced blood flow velocity in the anterior cerebral artery due to leptomeningeal collateralization was used as a corroborating criterion. With frequent follow-up examinations, we monitored reperfusion of the M1 segment resulting from recanalization or embolus migration in 16 patients. Those patients undergoing recanalization within days after onset of the first symptoms revealed variable clinical courses and lesion patterns on computed tomography, indicating the crucial importance of early and efficient leptomeningeal collateral blood supply. Transcranial Doppler ultrasonography was able to exclude middle cerebral artery occlusion with accuracy, which provides important clinical information. However, distal branch occlusions could not be detected with sufficient exactness.
我们评估了经颅多普勒超声对23例急性大脑中动脉闭塞患者的疗效。当除患侧大脑中动脉外所有基底动脉均能检测到时，闭塞的诊断最具提示性。大脑前动脉因软脑膜侧支循环导致的血流速度增加被用作佐证标准。通过频繁的随访检查，我们监测了16例患者因再通或栓子迁移导致的M1段再灌注情况。那些在首次症状出现数天内发生再通的患者在计算机断层扫描上显示出不同的临床病程和病变模式，这表明早期和有效的软脑膜侧支血供至关重要。经颅多普勒超声能够准确排除大脑中动脉闭塞，这提供了重要的临床信息。然而，远端分支闭塞无法被足够精确地检测到。
