Carotid Doppler Ultrasonography Evaluation in Patients with Storke

Kamarul Jaman, A (2007) Carotid Doppler Ultrasonography Evaluation in Patients with Storke. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.

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Abstract

INTRODUCTION : Stroke is defined as rapid onset of focal neurological deficit resulting from diseases of cerebral vasculature and its contents1. Community surveys in India have shown a crude prevalence rate for hemiplegia in the range of 200 per 100,000 persons, nearly 1.5% of all urban hospital admission, 4.5% of all medical and around 20% of neurological cases.1 Stroke is one of the leading causes of mortality and morbidity. Ischemic infarcts account for 80-85% of all strokes. Stroke related neurological disability has a major impact on the patient, family members and caretakers. 17% will remain institutionalized and 25-30% will need moderate to total assistance for activities of daily living2. Carotid atherosclerosis is one of the main risk factor for ischemic stroke which accounts for 5-10% of all ischemic stroke3. Carotid endarterectomy has been shown to effectively reduce the risk of developing stroke in patients with significant stenosis i.e. 70% or more. Various noninvasive vascular techniques can now be used to evaluate Carotid atherosclerosis which includes Carotid Doppler Ultrasonography, transcranial Doppler, CT angiography, Magnetic Resonance angiography, contrast enhanced Magnetic Resonance angiography. Among the tests Carotid Doppler ultrasound is a noninvasive, cost effective and easy available mode of investigation to identify the patients with significant stenosis and other changes due to atherosclerosis. AIMS OF THE STUDY : 1. To study the role of Carotid Doppler Ultrasonography in the diagnosis and management of stroke patients. 2. To study retrospectively the various abnormalities in Carotid arteries in patients who had suffered stroke. 3. To determine the usefulness of doing Carotid Doppler Ultrasonography as a screening procedure in predicting the chance of developing stroke in persons having risk factors for stroke. MATERIALS AND METHODS : The study was conducted in Department of Medicine, Government Mohan Kumaramangalam medical college, Salem in the year 2005-2006. Inclusion Criteria : Patients who suffered ischemic stroke in the anterior circulation of the brain as confirmed by CT scan brain. Exclusion Criteria : 1. Patients who suffered stroke due to intracerebral hemorrhage. 2. Patients who suffered stroke due to head injury. Methods : In this study patients who are admitted with history of sudden onset of neurological illness are subjected to CT scan brain. Among them patients who had suffered ischemic stroke in the anterior circulation are selected and they were further evaluated in the following ways. 1. Detailed history taking for the evaluation of risk factors such as hypertension, diabetes mellitus, smoking, previous TIA, previous stroke and coronary artery disease. 2. Complete physical examination to know the type of cerebrovascular accident (for right / left hemiplegia) and Carotid artery examination for the presence of bruit. 3. Laboratory investigation which include blood sugar, serum total cholesterol, ECG and Carotid Doppler Ultrasonography. CONCLUSION : 1. Doppler Ultrasonography of Carotid arteries shows significant changes due to atherosclerosis in the patients who suffered stroke. 2. Abnormalities in the vessel wall is more pronounced than the flow disturbances due to stenosis. 3. Since most of the patients showed changes in the contra lateral sides and ECG changes suggestive of ischemic heart diseases it is taken as an evidence of generalized vascular disease due to atherosclerosis. 4. Arterial wall motion abnormalities and plaque characteristics by tissue Doppler imaging is more useful in predicting the risk of stroke than detecting flow pattern abnormalities. 5. Carotid Doppler Ultrasonography cannot substitute for angiography as the sole preoperative tests for Carotid endarterectomy. 6. However it can be used as a screening test for the detection of the asymptomatic Carotid disease in patients with risk factors for stroke.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Carotid Doppler Ultrasonography ; Patients ; Storke.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 16 Feb 2018 15:42
Last Modified: 16 Feb 2018 15:42
URI: http://repository-tnmgrmu.ac.in/id/eprint/5764

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