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Mechanism of ischemic stroke in patients with middle cerebral artery stenosis.

Gao Shan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 191-194). / Abstracts in English and Chinese. / Abstract in English --- p.i / Abstract in Chinese --- p.iii / Acknowledgement --- p.v / Introduction --- p.vi / Contents --- p.viii / List of tables --- p.xiv / List of figures --- p.xv / Chapter Chapter One --- Literature Review / Chapter 1.1 --- Middle Cerebral Artery (MCA) Stenos --- p.is / Chapter 1.1.1 --- Prevalence of atherosclerotic MCA stenosis --- p.2 / Chapter 1.1.2 --- Methods for diagnosis of MCA stenosis --- p.3 / Chapter 1.1.3 --- Possible mechanism and course of stroke with MCA stenosis --- p.4 / Chapter 1.1.4 --- Treatment and prevention of stroke in patients with MCA stenosis --- p.5 / Chapter 1.2 --- Microembolic Signal (MES) Detection / Chapter 1.2.1 --- Introduction --- p.9 / Chapter 1.2.2 --- Technology --- p.9 / Characteristics of MES / Factors that affect MES detection / Problems of technology / Chapter 1.2.3 --- Clinical application --- p.15 / MES originating from atherosclerotic carotid artery stenosis / MES detection in internal carotid endarterectomy (CEA) / MES detection in patients with MCA stenosis / Predicting value and application in therapeutic trial / References --- p.19 / Chapter Chapter Two --- General Methodology / Chapter 2.1 --- Transcranial Doppler (TCD) Diagnosis for Intracranial Artery Stenosis / Chapter 2.1.1 --- TCD spectrum and common parameters --- p.29 / Chapter 2.1.2 --- Emitting and receiving transducers --- p.29 / Chapter 2.1.3 --- Pulsitility index (PI) --- p.31 / Chapter 2.1.4 --- Insonation depth and flow direction --- p.31 / Chapter 2.1.5 --- Continuous wave (CW) and pulsed wave (PW) --- p.33 / Chapter 2.1.6 --- Normal intracranial arteries through temporal and suboccipital window --- p.33 / Chapter 2.1.7 --- Normal intracranial arteries through orbital window --- p.36 / Chapter 2.1.8 --- Normal extracranial arteries --- p.36 / Chapter 2.1.9 --- TCD diagnosis for intracranial artery stenosis --- p.39 / Chapter 2.1.10 --- Example of multiple intracranial arteries stenosis --- p.39 / Chapter 2.2 --- Microembolic Signal (MES) Detection / Chapter 2.2.1 --- Device of MES monitoring --- p.41 / Chapter 2.2.2 --- Insonated artery and depth --- p.41 / Chapter 2.2.3 --- Axis length of the sample volume --- p.43 / Chapter 2.2.4 --- Fast Fourier Transform (FFT) time window overlap --- p.43 / Chapter 2.2.5 --- Distinguishing embolic signal and artifact with two-gate transducer --- p.45 / Chapter 2.2.6 --- Measurements of embolic signal and threshold --- p.47 / References --- p.45 / Chapter Chapter Three --- Prevalence and Clinical Significance of Microembolic Signal (MES) in Patients with Middle Cerebral Artery (MCA) Stenosis / Chapter 3.1 --- Abstract --- p.50 / Chapter 3.2 --- Introduction --- p.51 / Chapter 3.3 --- Methodology --- p.51 / Patients / Severity of stroke and clinical course / Diagnosis for middle cerebral artery (MCA) stenosis / Microembolic signal (MES) detection / Statistical analysis / Chapter 3.4 --- Results --- p.55 / Baseline information of patients / Prevalence of MES / Relationship between presence of MES and severity of MCA stenosis / Correlation between presence of MES and clinical course in 85 symptomatic patients / Correlation between the count of MES and clinical course in 85 symptomatic patients / Correlation between the presence of MES and further ischemic stroke / Chapter 3.5 --- Discussion --- p.63 / Prevalence of MES / Association between severity of stroke and presence or the number of MES / Predictive value of MES for further stroke / References --- p.66 / Chapter Chapter Four --- Mechanisms of Acute Cerebral Infarction in Patients with Cerebral Artery Stenosis: a Diffusion-weighted Imaging and Microemboli Monitoring study / Chapter 4.1 --- Abstract / Chapter 4.2 --- Introduction --- p.72 / Chapter 4.3 --- Methodology --- p.73 / Patients / Microembolic signal (MES) detection by transcranial Doppler (TCD) / "Magnetic resonance imaging (DWI, MRI and MRA)" / Statistical analysis / Chapter 4.4 --- Results --- p.77 / Severity of MCA stenosis on MRA and pattern of infarct on DWI / Frequency and count of MES and its relationship with multiple and borderzone infarction on DWI / Chapter 4.5 --- Discussion --- p.79 / Frequency of MES / Pattern of cerebral infarcts on DWI / Relationship between MES and multiple infarcts on DWI / References --- p.83 / Chapter Chapter Five / Chapter Chapter Five-I --- Novel Observations of the Characteristics of Real Time Genesis of Thromboembolism in Middle Cerebral Artery Stenosis Detected by Transcranial Doppler / Chapter 5.1.1 --- Abstract --- p.90 / Chapter 5.1.2 --- Introduction --- p.91 / Chapter 5.1.3 --- Methodology --- p.91 / Characteristics of patients / "MRA, DWI and conventional TCD data" / MES monitoring method and overall data / Neuroimaging and MES monitoring data in all five patients / Signal analysis in off-line / Confirmation test for the origin of MES / Chapter 5.1.4 --- Results --- p.104 / Frequency of three special phenomena / Characteristics of three special phenomena / Results of confirmation test for embolic source / Chapter 5.1.5 --- Discussion --- p.133 / Occurrence of MES with flow velocity change simultaneously / MES splatter / Bi-directional low frequency (S-velocity) vibration / Testing for source of MES detected from MCA stenosis / References --- p.139 / Chapter Chapter Five-II --- Characteristics of Microembolic Signals Detected near Its Origin from the Middle Cerebral Artery Stenosis / Chapter 5.2.1 --- Abstract --- p.143 / Chapter 5.2.2 --- Introduction --- p.144 / Chapter 5.2.3 --- Methodology --- p.144 / Patients / Microembolic signal (MES) detection / Classification of MES / Chapter 5.2.4 --- Results --- p.145 / Types of MES detected from MCA stenosis / Characteristics of three types of MES / Chapter 5.2.5 --- Discussion --- p.157 / Emboli moving from vessel wall to the center / Emboli vibration / About calculating the time delay between two channels / References --- p.160 / Chapter Chapter Five-III --- "Hemodynamic change,microembolic signal counts and use of antithrombotic treatments" / Chapter 5.3.1 --- Abstract --- p.163 / Chapter 5.3.2 --- Introduction --- p.164 / Chapter 5.3.3 --- Methodology --- p.164 / Chapter 5.3.4 --- Results / "The relationship among flow velocity, the number of MES and time since symptom onset" --- p.165 / Patient one / Patient two / Patient three / Chapter 5.3.5 --- Discussion / Association between flow velocity or MES change and different anticoagulants in acute stage / Progression of MCA stenosis after acute stage / Stability of MCA atherosclerotic stenosis / References --- p.173 / Chapter Chapter Six --- The Optimal Values of Flow Velocity on Transcranial Dopplerin Grading Severity of Middle Cerebral Artery Stenosis in Comparison With Magnetic Resonance Angiography / Chapter 6.1 --- Abstract --- p.179 / Chapter 6.2 --- Introduction --- p.180 / Chapter 6.3 --- Methodology --- p.180 / Patients / TCD examination / Grading of MCA stenosis on MRA / Statistical analysis / Chapter 6.4 --- Results --- p.182 / Detection of >50% MCA stenosis according to flow velocity / Grading severity of MCA stenosis by flow velocity / Chapter 6.5 --- Discussion --- p.186 / Reliability of TCD diagnosis for MCA stenosis / Grading MCA stenosis according to flow velocity on TCD / References / Abbreviations --- p.189 / Publications --- p.191

Identiferoai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_323987
Date January 2002
ContributorsGao, Shan., Chinese University of Hong Kong Graduate School. Division of Medical Sciences.
Source SetsThe Chinese University of Hong Kong
LanguageEnglish, Chinese
Detected LanguageEnglish
TypeText, bibliography
Formatprint, xviii, 194 leaves : ill. (some col.) ; 30 cm.
RightsUse of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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