Ge. Mead et al., Relationship between pattern of intracranial artery abnormalities on transcranial Doppler and Oxfordshire Community Stroke Project clinical classification of ischemic stroke, STROKE, 31(3), 2000, pp. 714-719
Background and Purpose-The Oxfordshire Community Stroke Project (OCSP) devi
sed a simple classification for acute stroke based on clinical features onl
y, which is of value in predicting prognosis. We investigated whether the p
attern of intracranial vascular abnormalities is related to the clinical sy
Methods-Patients with acute ischemic stroke were classified by a stroke phy
sician as having total or partial anterior circulation infarct (TACI or PAC
I, respectively), lacunar infarct (LACI), or posterior circulation infarct
(POCI), Color-coded power transcranial Doppler was done whenever possible.
Intracranial arterial velocities were compared in the 4 subtypes of ischemi
c stroke after adjustment for age and time to transcranial Doppler.
Results-Middle cerebral artery velocity was abnormal (hyperemia, reduced ve
locity, occlusion, or focal stenosis) in 38 of 69 TACIs (55%), 50 of 171 PA
CIs (29%), and 20 of 236 LACIs or POCIs (8%) (P<0.001), Velocity in the Al
segment of the anterior cerebral artery was reversed in 12 of 69 TACIs (17%
), 20 of 171 PACIs (12%), and 8 of 236 LACIs or POCIs (3%) (P<0.001). Basil
ar artery velocity was abnormal in 8 of 121 POCIs (7%) compared with 5 of 3
55 (1%) of the other subtypes (P=0.005). Vertebral artery velocity was abno
rmal (reduced velocity, occlusion, stenosis) in 20 of 121 POCIs (17%) compa
red with 20 of 355 others (6%) (P=0.01).
Conclusions-Intracranial arterial abnormalities were related to OCSP clinic
al subtype. Therefore, it is possible to stratify patients according to OCS
P classification in trials of new treatments in which treatment effectivene
ss may depend on the underlying pattern of arterial pathology and before an
y arterial imaging is available.