G. Tekgol Uzuner, N. Uzuner
Eskisehir Osmangazi University – Eskisehir, Turkey
Objective: We assessed the motor stimulus to blood flow velocity (BFV) changes of bilateral middle cerebral arteries (MCAs) by transcranial Doppler (TCD) sonography in patients with acute ischemic cerebrovascular events and normal subjects.
Material and Methods: Fourty-three patients (20 female, 23 male; aged 55.6 years) with acute territorial stroke in the MCA territory, 38 patients (11 female, 27 male; aged 57.6 years) with acute lacunar stroke in the MCA territory, and 19 control subjects (9 female, 10 male; aged 53.5 years) were investigated. Bilateral TCD sonography from both MCAs were monitored during 10 cycles of 20 seconds when subjects are performing hand gripping with a frequency of one per second, and subsequently 20 seconds when they are rest to assess BFV changes on activated cortical motor areas. BFV increase was calculated off-line for each subjects.
Results: There is no significant age and gender difference between patients and controls. Relative flow velocity increase was significantly lower (p<0.05) on the lesion side in the patients with territoral stroke (12.8±1.2) than those of lacunar stroke (21.5±1.2) or controls (19.0±2.2). However, in patients with territoral stroke non-lesion side the relative flow velocitiy increase was slightly lower (15.2±1.2) than those of lacunar strokes (23.5±1.7) or controls (19.6±1.9).
Discussion: Our results suggest that motor cortex was activated bilaterally even if one hemisphere was involved more or less. Cerebrovascular reactivity was preserved in patients with lacunar stroke in contrast to territorial stroke in the acute stage. Therefore, TCD sonography by means of vasoneuronal coupling may be use as a diagnostic tool in patients with acute ischemic stroke.
Key words: blood flow velocity, transcranial Doppler sonograph, vasoreactivity, ischemic stroke.