Transcranial Doppler sonographic findings in middle cerebral artery disease
H. Mattle, P. Grolimund, P. Huber, M. Sturzenegger and H. R. Zurbrugg
Department of Neurology, University of Bern, Inselspital, Switzerland.
The transcranial Doppler sonographic findings of 61 patients with middle
cerebral artery (MCA) disease were compared with those of 535 controls.
According to computed tomographic, angiographic, and/or autopsy findings,
the patients were classified as having MCA occlusive lesions in the central
(sphenoidal) part or in peripheral branches or MCA stenosis. With MCA
lesions, the MCA flow velocity (FV) was reduced. At the same time the
anterior cerebral artery FV increased because of collateral flow over
leptomeningeal anastomoses. Central MCA lesions showed less marked changes
than did peripheral lesions. In MCA stenosis a steep rise of MCA FV
appeared inside the stenotic segment. If there was a high-grade stenosis or
occlusion of the internal carotid artery, a collateral circulation over the
anterior part of the circle of Willis was seen in addition to the changes
caused by the MCA disease. From these hemodynamic changes, transcranial
Doppler sonographic diagnostic criteria for MCA occlusive and stenotic
lesions were established.
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