Yasmin Hasan, Muhammad Saleem Ilyas, Amir Mustafa Sheikh, Akhter Ahmed, Muhammad Abdullah.
Transcranial Doppler Sonography in Acute Ischaemic Stroke.
J Coll Physicians Surg Pak Jan ;12(6):331-4.

Objective: To evaluate the influence of time of recanalization in cardio-embolic or arterioarterial occlusion on infarct size and its effects on the clinical outcome after six weeks. Design: Observational case series study. Place and Duration of Study: Department of Neurology, DMC and Civil Hospital, Karachi, from July 1993 to December 1995. Material and Methods: Patients with acute stroke were selected from the Casualty Department of Civil Hospital, Karachi. Blood flow changes in the intracranial vessels were studied by Transcranial Doppler Sonography within six hours, after 24 hours and after one week. Patients were re-examined after 24 hours, 1 week and 6 weeks to determine the clinical outcome. CT scan was performed immediately after admission, later after 1 week. Results: In all 14 patients were selected, 11 males (age range 60 + 13 years) and 3 females (age range 54 + 9 years). Eight had right hemiparesis and six had left hemiparesis. Ten patients were heparinized. All patients had infarcts located in the middle cerebral artery territory. Seven patients had normal blood flow, 5 had blood flow between 20 to 40 cms /sec.and 1 had a blood flow below 20 cms/sec. One patient had absent temporal window. Eight patients showed clinical improvement, 3 were stable while condition of 2 deteriorated and they died. Conclusion: Initial TCD finding in an acute stroke can predict outcome by revealing a complete arterial occlusion or an early recanalization.

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