Carotid artery evaluation in ischemic stroke patients using Color Doppler imaging

Abstract

Background: Stroke is a major cause of mortality, morbidity, & health care expenditure globally. Carotid artery stenosis accounts for approximately 85% of all strokes. There is great value of safe, noninvasive and low cost screening test; therefore Doppler ultrasound study of carotid system is an important modality. Duplex Sonography, combining high resolution imaging and Doppler spectrum analysis has proved to be popular, non invasive, accurate and cost effective means of assessing carotid artery disease. Objective: 1.To assess carotid arteries with the help of color Doppler and -B mode imaging in carotid artery disease. 2. To correlate cerebrovascular accidents with extra cranial carotid artery status. Methods: This study was carried out in patients who had symptoms and signs of strokes, or transient ischemic attacks at a tertiary teaching hospital from the period of January 2015 to June 2016. The study was carried out on 94 patients. A detailed clinical history was taken and clinical examination findings were recorded. Risk factors like hypertension, diabetes mellitus, smoking and ischemic heart disease were documented. CT scan examination of the brain was carried out in all the patients and the findings were noted. Results: In this study, 79% of the patients were males and only 21% were females. The highest number of stroke patients in our study was found in the age group of 50-59 years which was 28%. Around 17% of patients had right MCA territory infarct, 9% had Left MCA territory infarct. Lacunar infarcts were seen in 33% patients. About 3% patients had right ACA territory infarct, 2% patients had left ACA infarct, 2%patients had right cerebellar infarct & 5% patients have age related cerebral atrophy. Normal study of brain was found in 25 patients in this study, 63% of patients had plaque in the carotid system. 47% of patients had plaque on the right side, 41% patients had plaque on the left side and 12% patients had bilateral involvement. Conclusion: Color Doppler examination is an economic, safe, reproducible and less time consuming method of demonstrating the cause of cerebrovascular insufficiency in the extra cranial carotid artery system and will guide in instituting treatment modalities.