Feb 27, 2010

Relative energy index of microembolic signal can predict malignant microemboli

Stroke; a Journal of Cerebral Circulation
Youngbin ChoiAndrew M Demchuk


Microembolic signals (MES) found on transcranial Doppler range from harmless air bubbles to large, solid, particulate emboli from the heart and large vessels. The presence of MES is not always associated with poor clinical outcome. The purpose of our study was to determine whether the relative energy index of MES measured by power M-mode Doppler can distinguish malignant from benign MES and to identify patients with worse prognosis. We prospectively collected transcranial Doppler emboli monitoring data from patients with symptomatic carotid stenosis presenting with TIA or ischemic stroke. For each patient, we calculated the relative energy index of MES and categorized those >1.0 as malignant MES. We compared the clinical characteristics, number, and volume of diffusion-weighted imaging lesions, and degree of stenosis and plaque characteristics on CT angiogram of patients with malignant and benign MES. We enrolled 92 patients, 29 with TIA and 63 with stroke, within 48 hours of symptom onset. Twenty-six patients had a total of 319 MES; of these, 82.4% were benign and were 17.6% malignant. Malignant MES traveled further within intracranial vessels than benign MES. The 9 patients with >1 malignant MES had significantly larger basel...Continue Reading

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Mentioned in this Paper

Ischemic Cerebrovascular Accident
Common Carotid Artery
Entire Carotid Artery
Dental Plaque
Doppler Studies
Meckel-Gruber Syndrome
Acute Cerebrovascular Accidents
Carotid Stenosis
Stenosis (invertebrate)

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