Cerebral microembolism in symptomatic and asymptomatic high-grade internal carotid artery stenosis. 1994

M Siebler, and A Kleinschmidt, and M Sitzer, and H Steinmetz, and H J Freund
Department of Neurology, Heinrich-Heine-University, Düsseldorf, Germany.

Using transcranial Doppler (TCD) ultrasonography in patients with high-grade (> or = 70%) internal carotid artery (ICA) stenosis, we examined the relation between the rate of TCD-detected silent microembolism of the ipsilateral middle cerebral artery and a history of recent (< 121 days) ischemic symptoms attributable to the diseased ICA. In the so-defined neurologically symptomatic group (n = 33 patients), silent microembolic events occurred in 27 subjects (overall mean rate, 14/h +/- 29). Among 56 neurologically asymptomatic patients matched for the degree of ICA stenosis, only nine showed such events (overall mean rate, 0.35/h +/- 1.4). Across all 89 patients studied, an individual microembolic event rate > or = 2/h had a positive predictive value of 0.88 for a history of recent symptoms. Our data suggest that TCD monitoring can provide reliable paraclinical evidence of "unstable ICA disease."

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D002343 Carotid Artery, Internal Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose. Arteries, Internal Carotid,Artery, Internal Carotid,Carotid Arteries, Internal,Internal Carotid Arteries,Internal Carotid Artery
D002542 Intracranial Embolism and Thrombosis Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures. Brain Embolism and Thrombosis,Cerebral Embolism and Thrombosis,Embolism and Thrombosis, Brain
D002545 Brain Ischemia Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION. Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D016893 Carotid Stenosis Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3) Carotid Artery Narrowing,Carotid Ulcer,Carotid Artery Plaque,Carotid Artery Stenosis,Carotid Artery Ulcerating Plaque,Common Carotid Artery Stenosis,External Carotid Artery Stenosis,Internal Carotid Artery Stenosis,Plaque, Ulcerating, Carotid Artery,Stenosis, Common Carotid Artery,Stenosis, External Carotid Artery,Ulcerating Plaque, Carotid Artery,Artery Narrowing, Carotid,Artery Narrowings, Carotid,Artery Plaque, Carotid,Artery Plaques, Carotid,Artery Stenoses, Carotid,Artery Stenosis, Carotid,Carotid Artery Narrowings,Carotid Artery Plaques,Carotid Artery Stenoses,Carotid Stenoses,Carotid Ulcers,Narrowing, Carotid Artery,Narrowings, Carotid Artery,Plaque, Carotid Artery,Plaques, Carotid Artery,Stenoses, Carotid,Stenoses, Carotid Artery,Stenosis, Carotid,Stenosis, Carotid Artery,Ulcer, Carotid,Ulcers, Carotid
D017585 Ultrasonography, Doppler, Transcranial A non-invasive technique using ultrasound for the measurement of cerebrovascular hemodynamics, particularly cerebral blood flow velocity and cerebral collateral flow. With a high-intensity, low-frequency pulse probe, the intracranial arteries may be studied transtemporally, transorbitally, or from below the foramen magnum. Doppler Sonography, Transcranial,Doppler Transcranial Sonography,Doppler Transcranial Ultrasonography,Doppler Ultrasonography, Transcranial,Sonography, Transcranial Doppler,Ultrasonography, Transcranial Doppler,Neurosonology,Sonography, Doppler Transcranial,Transcranial Doppler Sonography,Transcranial Doppler Ultrasonography,Transcranial Sonography, Doppler,Transcranial Ultrasonography, Doppler,Ultrasonography, Doppler Transcranial,Neurosonologies

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