Transcranial color duplex sonography in post-stroke cognitive impairment

Abstract

Abstract Background and aim: Cognitive impairments after stroke occur due to the hypoperfusion and underlying vascular and degenerative pathology. Several studies have reported changes in cerebral haemodynamics in patients with post-strokecognitive impairment. Aim of this study was to evaluate transcranial color duplex sonography findings and to assess the associated vascular risk factors in patients with post-stroke cognitive impairment. Material and methods: We made a prospective study of 65 patients with post-stroke cognitive impairment and compared them 40 age matched controls. All patients had physical and neurological examination, laboratory blood analysis, Mini Mental Status Exam (MMSE), computer tomography (CT) and/or nuclear magnetic resonance (MRI) of the brain and transcranial color duplex sonography with measurement of peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (MV) and pulsatility index (PI) of medial cerebral artery (MCA)on both sides, with linear probe 2 MHz, Hitachi/Elcat Results: There were 38 male and 27 female patients, aged 64-82 years (mean age (SD) 73+-5 years). Most significant risk factor was hypertension present in 59 (90,7%) of the patients(p<0,05). Mean value (SD) of PSVMCA was 51,2(4,37), mean value (SD) of EDVMCA was 19,75(1,98), mean (SD) MV1MCA/MV2MCA was 37,2(4,5) cm/s and mean (SD) PI1MCA/PI2MCA was0,78 (0,14). We found decreased flow velocity of MCA and increased PI. These findings show a state of hypoperfusion in post-stroke cognitive impairment. Conclusion: This study shows presence of haemodynamic changes in patients with post-stroke cognitive impairment. These patients need careful management of vascular risk factors and regular follow-up.