Premium
Two Different Days of Transcranial Doppler Examinations Should Be Performed for Detection of Right‐to‐Left Shunt in Acute Stroke Patients
Author(s) -
Aoki Junya,
Kimura Kazumi,
Iguchi Yasuyuki,
Sakai Kenichiro,
Sakamoto Yuki,
Terasawa Yuka,
Shibazaki Kensaku,
Kobayashi Kazuto
Publication year - 2013
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2011.00660.x
Subject(s) - medicine , transcranial doppler , valsalva maneuver , stroke (engine) , acute stroke , right to left shunt , neurological examination , cardiology , patent foramen ovale , surgery , blood pressure , mechanical engineering , migraine , tissue plasminogen activator , engineering
BACKGROUND We investigated how many contrast‐transcranial Doppler (c‐TCD) examinations should be performed on different days in patients with acute stroke. METHODS Consecutive acute stroke patients within 24 hours of onset were enrolled. Presence of RLS was examined using c‐TCD examinations on days 1, 7, and 14. Each c‐TCD examination used one test without Valsalva maneuver (VM) and three tests with VM. Patients were diagnosed with RLS when TCD detected ≥1 microembolic signal on ≥1 c‐TCD examination on any of the days 1, 7, or 14. RESULTS One hundred seventy patients (105 men [62%]; median age, 74 [IQR, 66–81] years) were enrolled. RLS was diagnosed in 45 patients (26%). RLS was identified on day 1 in 30 patients (18%), on day 7 in 28 patients (16%), and on day 14 in 23 patients (14%; P = .143). Detection rate of RLS by combining day 1 and 7 examinations was significantly higher than that of day 1 alone (25% vs 18%, P < .001). However, the rate did not increase when results of day 14 were added (25% vs 26%, P = .250). CONCLUSIONS c‐TCD examinations should be performed on at least two different days to assess the prevalence of RLS.