MICRO EMBOLIC SIGNALS iN PATIENTS WITH CEREBRAL ISCHEMIC EVENTS

Background and Purpose: The aim of this study was to evaluate th.e micro embolic signals (MES) occurrence in patients with. isch.emic stroke using transcranial Doppler monitoring to find out diagnostic relevance. Methods: We prospectively performed bilateral multigated transcranial Doppler monitoring from both. middle cerebral arteries in 359 patients with an acute (4 weeks) cerebral ischemic event, and in 182 control subjects without a cerebral ischemic event. MES were analyzed according to the standardized protocol. Results: Patients with ischemic stroke hada significantly (p<0,00001) higher rate of MES occurrence (31,8%) than that of control subjects (5,5%). MES were detected significantly high.er in patients diagnosed as partial or total anterior circulation infarcts (39,1 %) than those of lacunar infarcts (26,0%) or than those of transient ischemic attacks (27,3%). Similar results were found according to neuroimaging findings [(normal (26,7%), lacunar infarction (26,7%), and territorial infarction (39,9%)) of the patients. Another result of this study is that MES was fottnd to be an independent risk factor for ischemic stroke as well as proven ones. Conclusions: Since MES were detected predominantly in patients with large-vessel territorial stroke, our results gave additional support to the reliability of MES detection by means of TCD. Secondly, MES was found to be an independent risk factor for ischemic stroke, and therefore our data underlines the importance of transcranial Doppler monitoring for detecting MES in ischemic cerebral events.