Assessment of Cerebral Blood Flow in Patients with Acute Ischemic Stroke Submitted for Thrombolytic Therapy Using Trans-Cranial Color-Coded Doppler and Duplex | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2024, Issue 10, October 2024 | ||||
| DOI: 10.58675/2682-339X.2658 | ||||
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| Authors | ||||
| Mahmoud Monzer1; Abdelnaby Mohammed2; Ahmed Ali1; Mahmoud Hantour1 | ||||
| 1Neurology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| 2Diagnostic and Interventional Radiology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Transcranial duplex is a non-invasive and reliable technology that can be used to evaluate blood flow within the brain in cases of acute ischemic stroke and to determine the effectiveness of revascularization procedures. Aim and objectives: To illustrate the use of the transcranial color-coded Doppler and duplex in evaluating cerebral blood flow in patients who have been diagnosed with an acute ischemic stroke and are being considered for thrombolytic therapy. Patients and methods: In this cross-sectional study, 30 patients were selected from December 2022 to December 2023 and admitted to the emergency department and stroke unit at Al-Azhar University Hospital with a diagnosis of ischemic stroke based on clinical and radiological findings. Results: Our study involved 30 patients with acute ischemic Stroke with an age range of 25 to 79 (mean age 56.7±16.55 yrs SD); 63.3% were male, and 36.7% were female. TCD assessments were conducted before and after rTPA injection to evaluate cerebral blood flow. Before thrombolysis, TCD findings showed significant increases in systolic velocity, mean velocity, pulsatile index, and flow diversion compared to the normal contralateral side, all with P values<0.001 with significant Improvements in that TCD parameters post-thrombolysis (P value<0.005) in comparison to MRA, TCD showed a sensitivity of 85.7% and specificity of 88.89% with an overall accuracy of 86.89% while there is significant negative correlation with ASPECT score and positive with NIHSS score before and after rTPA. Conclusion: By providing real-time insights into cerebral hemodynamics and treatment response, TCD holds high sensitivity and specificity promise for optimizing therapeutic decision-making and improving clinical outcomes in these patient populations. | ||||
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