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Background <p>Prediction of long-term outcome in acute ischemic stroke (AIS)&#xa0;can impact the management and caregiver prognostication. The utility of serial transcranial Doppler (TCD) in predicting long-term disability and functional independency is uncertain. This study intended to&#xa0;correlate&#xa0;change in functional outcome in AIS with hemodynamic changes recorded by TCD.</p> Results <p>This was a prospective, observational, descriptive single-center study from India in AIS patients attending emergency room (ER) within 24 h after ictus. Data on sociodemographic, clinical (including NIHSS), treatment related and disability related [including modified Rankin score (mRS) and Barthel index (BI)] parameters were recorded at baseline. TCD was done at baseline&#xa0;and at 48 h and&#xa0;thrombolysis in brain ischemia&#xa0;(TIBI)&#xa0;flow grading&#xa0;calculated. NIHSS, mRS and BI were recorded on day 2, 30 and 90. Thirty-four patients were included and 16 (47.05%) underwent intravenous thrombolysis. Improvement in TIBI score at 48 h significantly correlated with improvement in clinical severity that is NIHSS at 48 h (<i>P</i> = 0.019), irrespective of treatment received. Majority with improvement of TIBI flow grade at 48 h (80.76%),&#xa0;had improvement in mRS at 30 and&#xa0;90 days&#xa0;(<i>P</i> = 0.09). Similarly, this subset also had improvement in BI&#xa0;at 90 days&#xa0;(<i>P</i> = 0.03).</p> Conclusions <p>In AIS patients, serial improvement in&#xa0;TCD flow significantly correlates&#xa0;with improvement in clinical severity and&#xa0;late disability and functional status irrespective of treatment.</p>

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Early hemodynamic changes on transcranial Doppler as a predictor of functional outcome in acute ischemic stroke: a case series from India

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  • 发表日期：

    2025年6月16日

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  • Pratik Patel,
  • Samhita Panda,
  • Sarbesh Tiwari

摘要

Background

Prediction of long-term outcome in acute ischemic stroke (AIS) can impact the management and caregiver prognostication. The utility of serial transcranial Doppler (TCD) in predicting long-term disability and functional independency is uncertain. This study intended to correlate change in functional outcome in AIS with hemodynamic changes recorded by TCD.

Results

This was a prospective, observational, descriptive single-center study from India in AIS patients attending emergency room (ER) within 24 h after ictus. Data on sociodemographic, clinical (including NIHSS), treatment related and disability related [including modified Rankin score (mRS) and Barthel index (BI)] parameters were recorded at baseline. TCD was done at baseline and at 48 h and thrombolysis in brain ischemia (TIBI) flow grading calculated. NIHSS, mRS and BI were recorded on day 2, 30 and 90. Thirty-four patients were included and 16 (47.05%) underwent intravenous thrombolysis. Improvement in TIBI score at 48 h significantly correlated with improvement in clinical severity that is NIHSS at 48 h (P = 0.019), irrespective of treatment received. Majority with improvement of TIBI flow grade at 48 h (80.76%), had improvement in mRS at 30 and 90 days (P = 0.09). Similarly, this subset also had improvement in BI at 90 days (P = 0.03).

Conclusions

In AIS patients, serial improvement in TCD flow significantly correlates with improvement in clinical severity and late disability and functional status irrespective of treatment.