(Longitudinal Follow-up of Middle Cerebral Artery Stenosis with Transcranial Doppler Ultrasonography: Preliminary Study)

Lee, Jae Hong; Choi, Choong Gon

Abstract

BACKGROUND: The natural history of intracranial arterial stenoses, particularly the middle cerebral artery (MCA), remains unknown. To monitor the progression of MCA stenoses over time, we conducted a prospective study using transcranial Doppler (TCD) study.
METHODS
We performed TCD study on 14 stroke patients with angiographically documented MCA stenosis. The findings were compared to repeat TCD studies conducted more than 2 months apart with respect to changes in mean flow velocities (mFV) of the stenotic segment.
RESULTS
Fourteen patients (13 men and 1 woman; mean age, 51 years) with 18 MCA stenoses were identified. During a mean follow-up period of 7.7 months, mFV corresponding to the areas of stenosis was increased in 7 (39%) arteries, demonstrating TCD evidence of stenosis progression. Three of those with MCA stenosis progression detected on TCD were confirmed with magnetic resonance angiogram. Flow velocities were not significantly changed in the remainder of the stenotic MCAs. Two patients whose MCA stenosis progressed also showed the suspicious development of new stenosis (mFV increase 119% and 41%, respectively) in the initially normal contralateral MCA.
CONCLUSION
These findings suggest that MCA stenoses are dynamic lesions, and that they can evolve and cause further reductions of the arterial diameters after relatively short periods of time. TCD can noninvasively detect these changes.