Venkatakrishnan Srikant, Khanna Meeka, Gupta Anupam
Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
J Neurosci Rural Pract. 2022 Jan 12;13(1):129-133. doi: 10.1055/s-0041-1742158. eCollection 2022 Jan.
Transcranial color-coded duplex sonography (TCCD) provides information on intracranial blood flow status in stroke patients and can predict rehabilitation outcomes. This study aimed to assess middle cerebral artery (MCA) parameters using TCCD in MCA territory stroke patients admitted for rehabilitation and correlate with clinical outcome measures. Patients aged 18 to 65 years with a first MCA territory stroke, within 6 months of onset were recruited. The clinical outcome scales and TCCD parameters were assessed at both admission and discharge. The scales used were the Scandinavian stroke scale (SSS), Barthel Index (BI), modified Rankin Scale (mRS), Fugl-Meyer upper extremity scale (FMA-UE), modified motor assessment scale (mMAS) scores. TCCD parameters measured were MCA peak systolic, end diastolic, mean flow velocities (MFV), and index of symmetry (SI) and were correlated with clinical scores. Fourteen patients were recruited with median age of 56.5 years, median duration of stroke was 42.5 days. Mean flow velocities of affected and unaffected MCA were 46.2 and 50.7 cm/s, respectively. Flow velocities and SI did not change between the two assessments. There was significant improvement in clinical outcome scores at discharge. Significant correlation was observed for patient group with SI > 0.9 at admission with FMA-UE, SSS, and BI scores at discharge ( < 0.05). Flow velocity parameters did not change during in-patient rehabilitation. Patients with symmetric flow at admission had improved clinical outcomes measure scores at discharge. Thus SI can predict rehabilitation outcomes in stroke survivors.
经颅彩色编码双功超声检查（TCCD）可提供中风患者颅内血流状态的信息，并能预测康复结果。本研究旨在使用TCCD评估因康复入院的大脑中动脉（MCA）区域中风患者的MCA参数，并将其与临床结局指标相关联。招募年龄在18至65岁之间、首次发生MCA区域中风且发病6个月内的患者。在入院和出院时评估临床结局量表和TCCD参数。使用的量表包括斯堪的纳维亚中风量表（SSS）、巴氏指数（BI）、改良Rankin量表（mRS）、Fugl-Meyer上肢量表（FMA-UE）、改良运动评估量表（mMAS）评分。测量的TCCD参数为MCA的收缩期峰值、舒张末期、平均流速（MFV）和对称指数（SI），并与临床评分相关联。招募了14名患者，中位年龄为56.5岁，中位中风持续时间为42.5天。患侧和未患侧MCA的平均流速分别为46.2和50.7厘米/秒。两次评估之间流速和SI没有变化。出院时临床结局评分有显著改善。入院时SI>0.9的患者组与出院时的FMA-UE、SSS和BI评分之间存在显著相关性（<0.05）。住院康复期间流速参数没有变化。入院时血流对称的患者出院时临床结局测量评分有所改善。因此，SI可以预测中风幸存者的康复结果。
