Transcranial Doppler Ultrasound Monitoring in Patients with Middle Cerebral Artery Main Stem Occlusion

Objective:To explore the changes of cerebral blood flow,collateral compensative capacity and the artery recanalization in patients with middle cerebral artery (MCA) main stem occlusion. Methods: Ninety two patients with MCA main stem occlusion determined by digital subtraction or MR angiography were measured by transcranial Doppler (TCD). Results: TCD findings in 24 hours after clinical onset were that flow signal of lesion side MCA disappeared in 62 patients (67%) with acute occlusion and blood flow velocity of lesion side MCA remarkably reduced (mean flow velocity 22±8cm/s) in 30 patients (33%) with chronic progressive occlusion. Eighty four patients(91%)showed blood flow velocity compensative acceleration of the lesion side anterior cerebral artery. Eight patients(9%) showed blood flow velocity compensative acceleration of the lesion side posterior cerebral artery. The artery recanalization was seen in 40 patients with acute occlusion during 1-2 days (15 cases). 3-7 days (15 cases) and 7 days (10 cases) after stroke onset. Conclusions: TCD might further help to know the changes of cerebral blood flow and the artery recanalization in patients with MCA main stem occlusion. It is suggested that TCD might be important and objective index in evaluating the treatment effect and the prognosis of MCA occlusion patients.