Journal «Angiology and Vascular Surgery» • 

2000 • VOLUME 6 • №2

DETECTION OF CEREBRAL EMBOLISM IN PATIENTS WITH ATHEROSCLEROTIC STENOSES OF THE INTERNAL CAROTID ARTERIES

D.N. Dzhibladze, A.A. Tomilin, O.V. Lagoda

Despite the fact that cerebral embolism is recognized as one of the main causes of stroke, its real detection was for a long time difficult. The homogeneous soft and heterogeneous hypodense atherosclerotic plaques are conclusively regarded as potentially dangerous. However, they may substantially differ in the predominance of such components as atheromatosis, fibrosis, necrosis, vascularization, and organized hemorrhages. All this frequently changes to a large extent the embologenic potential of the plaque. Over some years the diagnosis of embolism was based on the indirect data. Introduction into clinical practice of transcranial ultrasound detection of microembolism noticeably broadened the potentialities of the diagnosis of artero-arterial embolism as a cause of stroke.

The aim of the present study was to define the quantitative and qualitative characteristics of cerebral microembolism using transcranial Doppler monitoring in patients with stenoses of the internal carotid arteries as dependent on the clinical course of disease and characteristics of the atherosclerotic plaque.

A study was undertaken of 37 patients suffering from atherosclerotic stenoses of the internal carotid arteries. All the patients were assessed by standard neurologic examination, duplex scanning of the great arteries of the head, transcranial Doppler monitoring, and angiography.

The relationship has been revealed between the quantitative and qualitative characteristics of microembolism and the structural features of the atherosclerotic plaque. In the group of patients with homogeneous soft atherosclerotic plaques, cerebral microembolism was identified in the overwhelming majority of cases whereas in patients with homogeneous dense plaques, the microembolic signals were not detected. In the presence of heterogeneous plaques, the microembolic signals were recorded largely in those patients, in whom the hypodense component in the plaque was predominant.

KEY WORDS: cerebral embolism, transcranial Doppler, stenoses of the internal carotid arteries.

P. 28-36

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