Stroke 2013 July-7

 

Two different days of transcranial Doppler examinations should be performed for detection of right-to-left shunt in acute stroke patients.

J Neuroimaging. 2013 Apr;23(2):175-9.

Aoki J, Kimura K, Iguchi Y, Sakai K, Sakamoto Y, Terasawa Y, Shibazaki K, Kobayashi K.

Department of Stroke Medicine, Kawasaki Medical School, Kurashiki-City, Okayama, Japan. aojyun@med.kawasaki-m.ac.jp

Abstract

BACKGROUND: We investigated how many contrast-transcranial Doppler (c-TCD) examinations should be performed on different days in patients with acute stroke.

METHODS: Consecutive acute stroke patients within 24 hours of onset were enrolled. Presence of RLS was examined using c-TCD examinations on days 1, 7, and 14. Each c-TCD examination used one test without Valsalva maneuver (VM) and three tests with VM. Patients were diagnosed with RLS when TCD detected ≥1 microembolic signal on ≥1 c-TCD examination on any of the days 1, 7, or 14.

RESULTS: One hundred seventy patients (105 men [62%]; median age, 74 [IQR, 66-81] years) were enrolled. RLS was diagnosed in 45 patients (26%). RLS was identified on day 1 in 30 patients (18%), on day 7 in 28 patients (16%), and on day 14 in 23 patients (14%; P = .143). Detection rate of RLS by combining day 1 and 7 examinations was significantly higher than that of day 1 alone (25% vs. 18%, P < .001). However, the rate did not increase when results of day 14 were added (25% vs. 26%, P = .250).

CONCLUSIONS: c-TCD examinations should be performed on at least two different days to assess the prevalence of RLS. Copyright © 2011 by the American Society of Neuroimaging.

PMID: 22188538

Supplementary picture:

Junya Aoki

 

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