For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
25
views
14
references
 Top references
cited by
1
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      301
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Patterns of Transcranial Doppler Flow Velocities in Recent Ischemic Stroke Patients

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Context:

          Intracranial atherosclerosis is a common cause of stroke in India. Transcranial Doppler (TCD) provides a noninvasive way to study basal intracranial blood vessels. The Oxfordshire Community Stroke Project (OCSP) classification is a simple clinical stroke classification system that has prognostic significance and has been associated with size and location of the infarct.

          Aim:

          This study was undertaken to identify patterns of TCD abnormalities in our stroke population particularly in relation to the OCSP classification.

          Setting and Design:

          A cross-sectional study was conducted at a tertiary care center in South India.

          Methods:

          Recent nondisabling ischemic stroke patients were studied. TCD was used to insonate bilateral middle cerebral, bilateral anterior cerebral, bilateral vertebral, and basilar arteries. Mean flow velocity was used to define normal or abnormal flow as per standard criteria.

          Statistical Methods:

          Association between abnormal flow velocities and OCSP classification was studied using Chi-square tests. Univariate and multivariate analysis was performed to determine factors associated with abnormal flow velocities.

          Results:

          Of the 59 participants studied, 42 (71%; 95% confidence interval [CI]: 57.3-84.7%) had abnormal flow velocities in one or more vessels and this was significantly associated with smoking (odds ratio = 5; 95% CI: 1.2–21.8). All abnormal flow velocities were blunted flow velocities. Anterior circulation flow velocity abnormalities were seen among all OCSP stroke subtypes, but posterior circulation flow abnormalities were associated with posterior circulation infarcts ( P = 0.03).

          Conclusion:

          Intracranial flow velocity abnormalities are frequent among Indian stroke population. Further studies are needed to characterize these abnormalities fully.

          Related collections

          Most cited references14

          • Record: found
          • Abstract: found
          • Article: not found

          Classification and natural history of clinically identifiable subtypes of cerebral infarction.

          J. Bamford, P Sandercock, M. Dennis … (1991)
          We describe the incidence and natural history of four clinically identifiable subgroups of cerebral infarction in a community-based study of 675 patients with first-ever stroke. Of 543 patients with a cerebral infarct, 92 (17%) had large anterior circulation infarcts with both cortical and subcortical involvement (total anterior circulation infarcts, TACI); 185 (34%) had more restricted and predominantly cortical infarcts (partial anterior circulation infarcts, PACI); 129 (24%) had infarcts clearly associated with the vertebrobasilar arterial territory (posterior circulation infarcts, POCI); and 137 (25%) had infarcts confined to the territory of the deep perforating arteries (lacunar infarcts, LACI). There were striking differences in natural history between the groups. The TACI group had a negligible chance of good functional outcome and mortality was high. More than twice as many deaths were due to the complications of immobility than to direct neurological sequelae of the infarct. Patients in the PACI group were much more likely to have an early recurrent stroke than were patients in other groups. Those in the POCI group were at greater risk of a recurrent stroke later in the first year after the index event but had the best chance of a good functional outcome. Despite the small anatomical size of the infarcts in the LACI group, many patients remained substantially handicapped. The findings have important implications for the planning of stroke treatment trials and suggest that various therapies could be directed specifically at the subgroups.
          Article 0 comments Cited 301 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis (SONIA) trial.

            Marc I Chimowitz, , J Rogg … (2007)
            Transcranial Doppler ultrasound (TCD) and magnetic resonance angiography (MRA) can identify intracranial atherosclerosis but have not been rigorously validated against the gold standard, catheter angiography. The WASID trial (Warfarin Aspirin Symptomatic Intracranial Disease) required performance of angiography to verify the presence of intracranial stenosis, allowing for prospective evaluation of TCD and MRA. The aims of Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis (SONIA) trial were to define abnormalities on TCD/MRA to see how well they identify 50 to 99% intracranial stenosis of large proximal arteries on catheter angiography. SONIA standardized the performance and interpretation of TCD, MRA, and angiography. Study-wide cutpoints defining positive TCD/MRA were used. Hard copy TCD/MRA were centrally read, blind to the results of angiography. SONIA enrolled 407 patients at 46 sites in the United States. For prospectively tested noninvasive test cutpoints, positive predictive values (PPVs) and negative predictive values (NPVs) were TCD, PPV 36% (95% CI: 27 to 46); NPV, 86% (95% CI: 81 to 89); MRA, PPV 59% (95% CI: 54 to 65); NPV, 91% (95% CI: 89 to 93). For cutpoints modified to maximize PPV, they were TCD, PPV 50% (95% CI: 36 to 64), NPV 85% (95% CI: 81 to 88); MRA PPV 66% (95% CI: 58 to 73), NPV 87% (95% CI: 85 to 89). For each test, a characteristic performance curve showing how the predictive values vary with a changing test cutpoint was obtained. Both transcranial Doppler ultrasound and magnetic resonance angiography noninvasively identify 50 to 99% intracranial large vessel stenoses with substantial negative predictive value. The Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis trial methods allow transcranial Doppler ultrasound and magnetic resonance angiography to reliably exclude the presence of intracranial stenosis. Abnormal findings on transcranial Doppler ultrasound or magnetic resonance angiography require a confirmatory test such as angiography to reliably identify stenosis.
            Article 0 comments Cited 79 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Assessment: transcranial Doppler ultrasonography: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

              C Tegeler, V Babikian, Peter D. Newell … (2004)
              To review the use of transcranial Doppler ultrasonography (TCD) and transcranial color-coded sonography (TCCS) for diagnosis. The authors searched the literature for evidence of 1) if TCD provides useful information in specific clinical settings; 2) if using this information improves clinical decision making, as reflected by improved patient outcomes; and 3) if TCD is preferable to other diagnostic tests in these clinical situations. TCD is of established value in the screening of children aged 2 to 16 years with sickle cell disease for stroke risk (Type A, Class I) and the detection and monitoring of angiographic vasospasm after spontaneous subarachnoid hemorrhage (Type A, Class I to II). TCD and TCCS provide important information and may have value for detection of intracranial steno-occlusive disease (Type B, Class II to III), vasomotor reactivity testing (Type B, Class II to III), detection of cerebral circulatory arrest/brain death (Type A, Class II), monitoring carotid endarterectomy (Type B, Class II to III), monitoring cerebral thrombolysis (Type B, Class II to III), and monitoring coronary artery bypass graft operations (Type B to C, Class II to III). Contrast-enhanced TCD/TCCS can also provide useful information in right-to-left cardiac/extracardiac shunts (Type A, Class II), intracranial occlusive disease (Type B, Class II to IV), and hemorrhagic cerebrovascular disease (Type B, Class II to IV), although other techniques may be preferable in these settings.
              Article 0 comments Cited 76 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Indian Acad Neurol
                Journal ID (iso-abbrev): Ann Indian Acad Neurol
                Journal ID (publisher-id): AIAN
                Title: Annals of Indian Academy of Neurology
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0972-2327
                ISSN (Electronic): 1998-3549
                Publication date (Print): Jul-Sep 2018
                Volume: 21
                Issue: 3
                Pages: 193-196
                Affiliations
                [1]Department of Neurology, JIPMER, Puducherry, India
                Author notes
                Address for correspondence: Dr. Rajeswari Aghoram, Department of Neurology, SS Block, JIPMER, D. Nagar, Puducherry - 605 006, India. E-mail: rajeswari.a@ 123456gmail.com
                Article
                Publisher ID: AIAN-21-193
                DOI: 10.4103/aian.AIAN_417_17
                PMC ID: 6137640
                SO-VID: ffaf69cd-53ef-42a6-8770-5560defd1ded
                Copyright © Copyright: © 2018 Annals of Indian Academy of Neurology
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Neurology
                Keywords: blunted flow velocities,oxfordshire community stroke project classification,transcranial doppler
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: blunted flow velocities, oxfordshire community stroke project classification, transcranial doppler

                Comments

                Comment on this article

                scite_

                Similar content301

                See all similar

                Cited by1

                See all cited by

                Most referenced authors234

                See all reference authors