Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex

Abstract Background In acute ischemic stroke, collateral circulation plays an important role in maintaining blood flow to the tissue that is at risk of progressing into ischemia, and in increasing the successful recanalization rate without hemorrhagic transformation. Objectives To compare between co...

पूर्ण विवरण

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मुख्य लेखकों: Sara Hamdy, Hani Mohamed Amin Aref, Ramez Reda, Ahmed ElSadek
स्वरूप: लेख
भाषा:English
प्रकाशित: SpringerOpen 2019-02-01
श्रृंखला:The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
विषय:
ऑनलाइन पहुंच:http://link.springer.com/article/10.1186/s41983-019-0061-3
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author Sara Hamdy
Hani Mohamed Amin Aref
Ramez Reda
Ahmed ElSadek
author_facet Sara Hamdy
Hani Mohamed Amin Aref
Ramez Reda
Ahmed ElSadek
author_sort Sara Hamdy
collection DOAJ
description Abstract Background In acute ischemic stroke, collateral circulation plays an important role in maintaining blood flow to the tissue that is at risk of progressing into ischemia, and in increasing the successful recanalization rate without hemorrhagic transformation. Objectives To compare between collaterals in patients with extracranial carotid stenosis alone and in patients having both extracranial and intracranial carotid stenosis and therefore the difference in prognosis between them. Materials and methods A total of 30 patients of acute ischemic stroke were enrolled. The extracranial part of the carotid artery was assessed with color-coded duplex. Transcranial color-coded duplex was done to assess cerebral hemodynamics and collaterals to differentiate between extracranial significant carotid stenosis alone versus combined extra- and intracranial significant carotid stenosis. Results Out of 15 patients with significant extracranial stenosis, 3 of them obtained reversed flow in the ophthalmic artery and 3 patients of them showed change of flow in the anterior cerebral artery(ACA), whereas the other 15 patients of combined stenosis did not show any reversed blood flow in the same arteries which considered nonsignificant. The residual deficit of patients with extracranial stenosis alone was better when compared to that of the other group. Conclusion Our study concluded that transcranial duplex provides useful information about cerebral reserve and status of collaterals which show nonsignificant difference between two studied groups regarding intracranial collaterals. Furthermore, patients with combined extra- and intracranial stenosis were found to have more deficit and worse prognosis than patients with internal carotid stenosis only.
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spelling doaj.art-aa288721e4634a8082a9cbe0dc8debf32022-12-22T01:18:49ZengSpringerOpenThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery1687-83292019-02-015511610.1186/s41983-019-0061-3Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplexSara Hamdy0Hani Mohamed Amin Aref1Ramez Reda2Ahmed ElSadek3Neurology and Psychiatry, Ainshams UniversityNeurology and Psychiatry, Ainshams UniversityNeurology and Psychiatry, Ainshams UniversityNeurology and Psychiatry, Ainshams UniversityAbstract Background In acute ischemic stroke, collateral circulation plays an important role in maintaining blood flow to the tissue that is at risk of progressing into ischemia, and in increasing the successful recanalization rate without hemorrhagic transformation. Objectives To compare between collaterals in patients with extracranial carotid stenosis alone and in patients having both extracranial and intracranial carotid stenosis and therefore the difference in prognosis between them. Materials and methods A total of 30 patients of acute ischemic stroke were enrolled. The extracranial part of the carotid artery was assessed with color-coded duplex. Transcranial color-coded duplex was done to assess cerebral hemodynamics and collaterals to differentiate between extracranial significant carotid stenosis alone versus combined extra- and intracranial significant carotid stenosis. Results Out of 15 patients with significant extracranial stenosis, 3 of them obtained reversed flow in the ophthalmic artery and 3 patients of them showed change of flow in the anterior cerebral artery(ACA), whereas the other 15 patients of combined stenosis did not show any reversed blood flow in the same arteries which considered nonsignificant. The residual deficit of patients with extracranial stenosis alone was better when compared to that of the other group. Conclusion Our study concluded that transcranial duplex provides useful information about cerebral reserve and status of collaterals which show nonsignificant difference between two studied groups regarding intracranial collaterals. Furthermore, patients with combined extra- and intracranial stenosis were found to have more deficit and worse prognosis than patients with internal carotid stenosis only.http://link.springer.com/article/10.1186/s41983-019-0061-3Carotid stenosisCollateralsTranscranial color-coded duplex
spellingShingle Sara Hamdy
Hani Mohamed Amin Aref
Ramez Reda
Ahmed ElSadek
Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Carotid stenosis
Collaterals
Transcranial color-coded duplex
title Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex
title_full Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex
title_fullStr Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex
title_full_unstemmed Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex
title_short Comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra- and intracranial stenosis using transcranial duplex
title_sort comparison between intracranial collaterals and cerebral hemodynamics in patients with extracranial carotid stenosis versus combined extra and intracranial stenosis using transcranial duplex
topic Carotid stenosis
Collaterals
Transcranial color-coded duplex
url http://link.springer.com/article/10.1186/s41983-019-0061-3
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AT ramezreda comparisonbetweenintracranialcollateralsandcerebralhemodynamicsinpatientswithextracranialcarotidstenosisversuscombinedextraandintracranialstenosisusingtranscranialduplex
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