Vassileva E, Schnorf H, Personeni O, The potential value of microembolic signal detection by transcranial Doppler sonography in the clinical evaluation of patients with cerebrovascular disease is investigated and particular attention given to the prevalence of microembolic signals in different clinical groups. The present study was conducted on 158 patients, 100 of whom had 120 stenoses (moderate-grade in 69 arteries, highgrade in 38) or occlusions of the carotid artery (13 cases), and 58 of

more »

... m suffered from stroke of other aetiologies in the anterior circulation.Among the 120 stenoses and occlusions, 87 were asymptomatic and 33 were symptomatic.The cerebral vessels of the patients were evaluated by continuous wave Doppler sonography, colour-coded duplex scanning, transcranial Doppler sonography and digital substraction angiography. Cardiac examination included electrocardiography, Holter monitoring and echocardiography. Microembolic signals were found in patients only when a source of cerebral embolism was detected. Patients with vascular or cardiac embolism were likely to show microembolic signals, the frequency being not significantly different. microembolic signals were found in 33% of patients with carotid artery disease and in 31% of patients with cerebral embolism of cardiac source, 4 of the latter patients having a prosthetic cardiac valve. Microembolic signals were less prevalent in patients with moderate-grade (3/69) ICA stenosis than in patients with high-grade (9/38) stenosis (p <0.01), but more prevalent in patients with symptomatic high-grade (7/15) stenosis than in cases with asymptomatic (2/23) ones (p <0.05). Patients with moderate-grade stenoses and detectable microembolic signals should be further studied, as they might benefit from a more aggressive therapy, such as endarterectomy.