Koennecke H C, Trocio S H, Mast H, Mohr J P
Department of Neurology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
J Neuroimaging. 1997 Oct;7(4):217-20. doi: 10.1111/jon199774217.
High-intensity transient signals on transcranial Doppler sonography (TCD) are associated with atherosclerotic stenosis of the internal carotid artery. Few data exist regarding the detection of high-intensity transient signals in dissected carotid arteries. In the present study, 6 patients with spontaneous carotid dissection, defined by magnetic resonance techniques and duplex sonography, were examined by TCD. Both middle cerebral arteries were monitored simultaneously for 30 minutes. Four of the patients had ipsilateral cerebral ischemia, while 2 presented with other symptoms. High-intensity transient signals were detected in the middle cerebral artery ipsilateral to the dissection in 3 of the 4 patients with cerebral ischemia and in none of the patients with other presenting symptoms. No microemboli were found contralateral to the dissected arteries. Microemboli can be detected distally from dissected carotid arteries. The present findings support the assumption that embolism is a major cause of stroke in patients with carotid dissection, and suggest that high-intensity transient signals are more common among patients with cerebral ischemia secondary to dissection.
经颅多普勒超声检查（TCD）上的高强度瞬态信号与颈内动脉粥样硬化狭窄有关。关于在颈动脉夹层中检测高强度瞬态信号的数据很少。在本研究中，对6例经磁共振技术和双功超声检查确诊为自发性颈动脉夹层的患者进行了TCD检查。同时监测双侧大脑中动脉30分钟。4例患者出现同侧脑缺血，2例出现其他症状。4例脑缺血患者中有3例在夹层同侧的大脑中动脉检测到高强度瞬态信号，而有其他症状的患者均未检测到。在夹层动脉对侧未发现微栓子。在颈动脉夹层的远心端可检测到微栓子。本研究结果支持栓塞是颈动脉夹层患者中风的主要原因这一假设，并表明高强度瞬态信号在夹层继发脑缺血患者中更为常见。
