CEREBRAL MICROEMBOLISM IN PATIENTS WITH STROKE OR TRANSIENT ISCHEMIC ATTACK AS A RISK FACTOR FOR EARLY RECURRENCE

The incidence of early recurrence in 32 patients who had had a transie nt ischaemic attack or stroke in the anterior circulation was studied. Patients with a potential cardiac source of embolism were excluded fr om the study. All patients had transcranial Doppler (TCD) monitoring o f the symptomatic middle cerebral artery for microembolic signal detec tion within seven days from the onset of symptoms. Four patients had e arly recurrence during a mean follow up of 15 (SD11) days. All early r ecurrences occurred in the same arterial territory as the initial isch aemic event. Three of the four patients with early recurrence had prio r microembolic signals. The incidence of early recurrence was 50% (3/6 ) in patients with microembolic signals and 3.8% (1/26) in patients wi thout microembolic signals (P=0.02). The findings suggest that TCD mon itoring of patients with recent cerebral ischaemia of presumed arteria l origin allows recognition of a subset of patients at high risk for e arly recurrence.