Asymptomatic cerebral embolic signals in patients with acute cerebral ischaemia and severe aortic arch atherosclerosis

Severe aortic arch atheroma (AAA) is a strong risk factor for ischaemic str oke, but it is unclear whether AAA is a source of cerebral emboli or simply a marker of cerebral atherosclerosis. The purpose of this study was to fin d out the prevalence of asymptomatic cerebral embolic signals (ES) in patie nts with acute cerebral ischaemia,AAA and no other potential source of cere bral embolism. Forty patients with anterior circulation ischaemic stroke or transient ischaemic attack (TIA) were prospectively studied using trans-es ophageal echocardiography (TEE) and transcranial Doppler (TCD) scanning wit hin seven days of symptom onset. Patients with a cardiac source of embolism or carotid stenosis > 50 % were excluded. ES were detected in 14.3 (2/14) of patients with AAA greater than or equal to 4 mm and in no patients with AAA < 4 min or no AAA (p=0.14). The findings suggest that ES maybe associat ed with severe AAA but their prevalence is low in this setting.