THE ROLE OF CAROTID ECHO DOPPLER IN TREATMENT AND PREVENTION OF CEREBROVASCULAR DISEASE IN NON DIABETIC AND DIABETIC POPULATION AT HIGH RISK

Abstract

Abstract Objective: Stroke, the third leading cause of death is a cardiovascular disease that affects the blood vessels supplying blood to the brain. Diabetes mellitus which is one of the main risk factors of cerebrovascular disease (CVD). Aim: Echo Doppler evaluation of arteries in diabetic and non-diabetic elderly patients. Design and method: Patient selection: We selected 112 patients admitted in Neurology Clinic of Vlad Voiculescu Cerebrovascular Institute Bucharest: 63 non diabetics mean age 63 years with acute ischemic stroke (CT scan confirmed)in carotid territory or a TIA and 59 diabetic patients with risk factors: obesity and arterial hypertension mean age 62.8 included into this study, independently from the presence or absence of acute ischemic stroke investigated by CT/MRI. Results: The carotid Echo-Doppler examination applying a 4 MHz transducer for extracranial and transcranial vascular Doppler investigation performed in both groups of patients revealed that simple carotid plaques, bilateral carotid stenoses (CS), and unilateral CS associated with contralateral carotid occlusion (CO) occurred with higher frequency in the non-diabetic patients, than in diabetic ones. On the other hand, the remaining other findings, such as unilateral CS, unilateral CO, S/O of intracranial carotid artery (ICA) and vertebral/subclavian S were more frequent in the diabetic group. Conclusions: The findings allow us to conclude that the correct and early treatment of diabetes as well as a possible lowering of the risks for cerebrovascular disease are obligatory steps in the primary and secondary prevention of the cerebral ischemic events in diabetic patients with carotid atheromatous lesions. There are several approaches to reduce the risk of stroke in diabetics and physical exercise is a low cost with maximum benefit upon health status contributing to lowering of high blood pressure, and of HDL. This consideration may help the physicians to have a deeper understanding of the pathophysiology, and to implement the necessary treatment and prevention of CVD in the diabetic population of high-risk.