Progression or Regression of Middle Cerebral Artery Stenosis: a Long-term Follow-up Study with Transcranial Doppler Ultrasonography

J Korean Neurol Assoc > Volume 24(5); 2006 > Article

Journal of the Korean Neurological Association 2006;24(5): 435-439.

중뇌동맥 협착의 진행 또는 완화: 경두개초음파술을 이용한 추적 연구

김성민, 김현경 김범준 이용석

서울대학교 의과대학 신경과학교실, 서울대학교 보라매병원 신경과

Progression or Regression of Middle Cerebral Artery Stenosis: a Long-term Follow-up Study with Transcranial Doppler Ultrasonography

Sung-Min Kim

Department of Neurology, Seoul National University and Metropolitan, Boramae Hospital, Seoul, Korea

Abstract

Background: Atherosclerosis of intracranial vessels may progress or regress, however, the natural course of middle cerebral artery (MCA) stenosis has not been known well. Using Transcranial Doppler ultrasonography, we attempt to reveal the frequency and the associated factors about progression or regression of MCA stenosis.
Methods: Among patients with MCA stenosis on MRA (>50% narrowing), objects with repeated TCD examinations (interval >6 months) were included. Mean flow velocity (MFV) changes over than 30 cm/sec were used as criteria for progression, stationary or regression of MCA stenosis. Demographic data, risk factors, and medications were assessed to identify predictors of progression or regression.
Results: Eighty-one MCA segments were analyzed (36 males, mean age 64 years). Mean follow-up period was 614 days (210~1457 days). Progression and regression were detected in 18.5% and 14.8%. With multivariate regression analysis, no clinical profiles, risk factors, medications were associated with progression or regression of MCA stenosis.
Conclusions: With long term follow up, progression and regression of MCA stenosis is not uncommon, which means the intracranial atherosclerosis is a dynamic process. TCD seems to be useful in detecting progression or regression of MCA stenosis with optimal criteria. Predicting factors for progression and regression remain to be determined by further prospective, well-designed studies. KeyWords:Transcranial Doppler ultrasonography, Middle cerebral artery, Stenosis, Progression