Document Detail

Clinically silent circulating microemboli in 20 patients with carotid or vertebral artery dissection.
MedLine Citation:
PMID:  11641581     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Carotid and vertebral artery dissections are frequently complicated by cerebral embolism. Detection of clinically silent circulating microemboli by transcranial Doppler sonography (TCD) is now widely investigated in patients with carotid artery disease in the hope to identify patients at increased risk for stroke. METHODS: In 20 patients with carotid (n = 17) or vertebral (n = 2) artery dissection, or both (n = 1), we performed a 1-hour microembolus detection downstream to the dissection in the middle or in the posterior cerebral artery, respectively. RESULTS: Five patients with a carotid artery stenosis of > or = 90% or with carotid artery occlusion showed microembolic signals at a rate of up to 15 events/h. In all these patients, the onset of the dissection was within the last 58 days. Patients with lower degrees of stenosis or onset of symptoms beyond 58 days did not show microembolic signals at all. Three patients who had presented with recurrent ischaemic events prior to TCD monitoring unexceptionally had microembolic signals. CONCLUSION: Microembolic signals occur in patients with high-grade stenosis or occlusion due to acute cervical artery dissection. Patients with microemboli seem to be at increased macroembolic risk, i.e. stroke recurrence, and may require close-meshed clinical follow-up and possibly stronger antithrombotic treatment.
D W Droste; K Junker; F Stögbauer; S Lowens; M Besselmann; B Braun; E B Ringelstein
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  12     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2001  
Date Detail:
Created Date:  2001-10-19     Completed Date:  2002-01-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  181-5     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Department of Neurology, University of Münster, Germany.
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MeSH Terms
Aneurysm, Dissecting / complications*
Arterial Occlusive Diseases / complications
Carotid Artery Diseases / complications*
Carotid Stenosis / complications
Intracranial Aneurysm / complications*
Intracranial Embolism / etiology*,  ultrasonography
Ischemic Attack, Transient / complications
Middle Aged
Neck / blood supply
Ultrasonography, Doppler, Transcranial
Vertebral Artery*

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