Introduction: Dynamic monitoring of the patients presenting with suppressed consciousness during the acute stage of stroke plays an important role in the diagnostic and therapeutic process as a whole.
Aim: The objective of the present study was to analyze the initial results from the twofold transcranial Doppler sonography application in acute stroke patients with suppressed consciousness aiming at optimizing their timely treatment.
Materials and Methods: The histories of 46 patients, 21 males and 25 females, at a mean age of 75 years with acute stroke and a different degree of suppressed consciousness hospitalized during the period from January 1, 2018 to January 31, 2019 were analyzed. All the patients were examined by means of transcranial Doppler sonography. The degree of suppressed consciousness was evaluated by means of Glasgow-Liége Coma Scale.
Results: Thirty-four patients presented with acute ischemic stroke and 12 ones with acute hemorrhagic one. Several accompanying cardiovascular diseases that aggravated the course of the acute cerebrovascular accident were diagnosed. Considerable differences in terms of the mean values according to the Glasgow-Liége Coma Scale were observed. The intervals of the maximal, minimal and average sonographic parameters of four cerebral arteries such as left and right middle cerebral artery and left and right vertebral artery varied within broad limits, too.
Conclusion: The application of a constellation of various neuroimaging methods in the patients with acute cerebrovascular diseases could identify essential relationships between the parameters analyzed and risk factors as well as to give assistance to the individualized therapeutic approach.
Титянова Е. Ултразвукова диагностика в неврологията. София, Коти ЕООД, 2006. 223 с.
Aghoram R, Narayan SK. Patterns of transcranial Doppler flow velocities in recent ischemic stroke patients. Ann Indian Acad Neurol. 2018;21(3):193-196.
Andonova S, Mintchev D, Novakova M, Georgiev R. Correlative neurosonographic and neuroimaging studies in arterial hypertension and asymptomatic ischaemic disturbances of the cerebral circulation. Neurosonol Cerebr Hemodyn. 2009;5(1):17-22.
Iyer PC, Madhavan S. Non-invasive brain stimulation in the modulation of cerebral blood flow after stroke: A systematic review of transcranial Doppler studies. Clin Neurophysiol. 2018;129(12):2544-2551.
Minhas JS, Panerai RB, Ghaly G, Divall P, Robinson TG. Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta-analysis of transcranial Doppler ultrasonography studies. J Clin Ultrasound. 2019;47(1):14-21
Tasneem N, Samaniego EA, Pieper C, Leira EC, Adams HP, Hasan D, et al. Brain multimodality monitoring: a new tool in neurocritical care of comatose patients. Crit Care Res Pract. 2017;2017:6097265. doi: 10.1155/2017/6097265.
Topcuoglu MA. Transcranial Doppler ultrasound in neurovascular diseases: diagnostic and therapeutic aspects. J Neurochem. 2012;123 Suppl 2:39-51.
Wijnhoud AD, Koudstaal PJ, Dippel DW. The prognostic value of pulsatility index, flow velocity, and their ratio, measured with TCD ultrasound, in patients with a recent TIA or ischemic stroke. Acta Neurol Scand. 2011;124(4):238-244.
