Relationship between pattern of intracranial artery abnormalities on transcranial Doppler and Oxfordshire Community Stroke Project clinical classification of ischemic stroke

Citation
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
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology,"Cardiovascular & Hematology Research
Journal title
STROKE
ISSN journal
0039-2499 → ACNP
Volume
31
Issue
3
Year of publication
2000
Pages
714 - 719
Database
ISI
SICI code
0039-2499(200003)31:3<714:RBPOIA>2.0.ZU;2-5
Abstract
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 ndrome. 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.