Alterations in cranial blood flow in MCA stroke detected by Trans-cranial Doppler sonography

Considering that 85% of ischemic strokes take place in MCA (middle cerebral artery), and Trans-cranial Doppler sonography (TCD) is a sensitive and non-invasive diagnostic technique, the present study was aimed at assessing alterations in cranial blood flow in MCA in order to determine the prognosis after a stroke and to predict the likelihood of another stroke.

During this descriptive study, the anterior circulation arteries of 44 patients, suffering from MCA stroke for the first time, were evaluated using the TCD technique.

Peak systolic velocity (PSV) and mean flow velocity (MFV) of ipsilateral MCA were reduced resulting in more than 15% of asymmetry of flow in 61.4% of the patients (p<0.005). PSV and MFV of ACA were increased resulting in increased ratio of ipsilateral to contralateral ACA (ACAVR) in 72.2% of the cases (p<0.005). Pulsatility index (PI) of ipsilateral MCA to contralateral MCA was increased significantly indicating distal vascular resistance. Resistance index (RI) of ipsilateral and contralateral MCA did not differ significantly.

Ischemic MCA infarcts reduce PSV and MFV in ipsilateral MCA and increase PSV and MFV in ipsilateral ACA, resulting in increased ipsilateral ACAVR, which is the most valuable parameter in determining MCA infarct. RI value did not correlate with the final size of the infarct.