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Prognostic use of ultrasonography in acute non-hemorrhagic carotid stroke

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Abstract

In order to evaluate whether the results of ultrasound examination may be associated with 30-day outcome, 76 consecutive patients (43 men and 33 women; mean age 68.1±8.9 years) underwent duplex scanning of the carotid bifurcations and transcranial doppler investigation of the basal skull arteries within the first few hours of the onset of an acute carotid stroke. Forty-three patients (56.6%) had appropriate arterial occlusion at ultrasounds examination. On day 30, 22 patients (28.9%) were self-sufficient, 41 (53.9%) were disabled and 13 (17.1%) were dead. The chisquared test showed that the ultrasound results were significantly related to 30-day outcome (p=.0003).

After logistic regression analysis, the ultrasound results remained independent predictors of 30-days outcome (p=.0129), together with neurological impairment 24 hours after stroke onset and lesion size at control computed tomography.

Our study suggests that the results of ultrasound examination may be useful in the management of acute carotid stroke as an early indicator of patients with a worse prognosis.

Sommario

Abbiamo sottoposto 76 pazienti consecutivi, di età media di 68.1±8.9 anni, ricoverati per un primo ictus ischemico nei territori carotidei, a studio ecodoppler delle biforcazioni carotidee e a doppler transcraniale delle arterie del basicranio, per valutare se le informazioni ricavate dagli studi ultrasonori potessero essere di aiuto a fini prognostici, 43 pazienti (56.6%) presentavano occlusione di una appropriata arteria agli ultrasuoni. A 30 giorni dall'ictus, 22 pazienti (28.9%) erano autosufficienti, 41 pazienti (53.9%) erano dipendenti e 13 pazienti (17.1%) erano morti.

Al test del Chi quadrato, i risultati degli ultrasuoni erano significativamente correlati alla prognosi a 30 giorni (p=.0003). Dopo analisi di regressione logistica multipla, i risultati degli ultrasuoni rimanevano indicatori prognostici indipendenti (p=.0129) insieme alle dimensioni della lesione ischemica alla TAC encefalo ripetuta tra il 4° e il 7° giorno dallo stroke e alla gravità neurologica a 24 ore dall'esordio dei sintomi. Il nostro studio suggerisce che gli ultrasuoni potrebbero essere utili nelle decisioni cliniche dei pazienti con stroke ischemico carotideo quali indicatori precoci di prognosi.

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Authors and Affiliations

  1. Divisione di Neurologia 2, Ospedali Riuniti, Largo Barozzi 1, I-24100, Bergamo, Italy

    Camerlingo M., Casto L., Censori B., Servalli M. C., Ferraro B. & Mamoli A.

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  1. Camerlingo M.
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  2. Casto L.
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  3. Censori B.
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  4. Servalli M. C.
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  5. Ferraro B.
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  6. Mamoli A.
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Camerlingo, M., Casto, L., Censori, B. et al. Prognostic use of ultrasonography in acute non-hemorrhagic carotid stroke. Ital J Neuro Sci 17, 215–218 (1996). https://doi.org/10.1007/BF01995686

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  • DOI: https://doi.org/10.1007/BF01995686

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