Contribution of Doppler Ultrasound of the Supra-Aortic and Transcranial Trunks in the Lesion Diagnosis of Ischemic Stroke at the Dogta-Lafiè Reference Hospital in Lomé (HDL) and the Kara University Hospital
Objective: Describe the contribution of Doppler ultrasonography of the cervical and encephalic arteries in the lesion diagnosis of ischemic strokes. Materials and Methods: This was a prospective descriptive and analytical study carried out from August 2022 to August 2024 (2 years) in the Doppler ultrasound room in the cardiology departments of Dogta-Lafiè Hospital in Lomé and Kara University Hospital. All patients who underwent Doppler ultrasonography of the cervical and encephalic arteries for ischemic stoke during the study period were included. Results: We selected 110 Doppler ultrasound scans for ischemic stroke. The mean age was 62.1 ± 12.6 years. The M/F sex ratio was 1.4. Cardiovascular risk factors included hypertension (40%), dyslipidemia (42.8%), diabetes (14.5%) and a history of ischemic stroke (09.1%). Doppler ultrasonography was normal in 22 patients, and significant lesions were present in 88 patients (80%). Significant stenoses were found in 60 patients (55%) and occlusions in 28 (25%). These lesions were intracranial (40.9%), extracranial (59.1%), or mixed (19.3%). Significant stenoses and occlusions involved the carotid system in 78.6% and the vertebrobasilar system in 21.4%. In the cervical region, bulbar carotid and post-bulbar stenoses accounted for 61.5%. In the encephalic region, stenoses of the middle and posterior cerebral arteries accounted for 61.1% and 30.5% of lesions respectively. Transcranial Doppler ultrasound revealed 23.9% (21 patients) of intracranial lesions in patients with normal Doppler at the cervical level. Diabetes increases the likelihood of stenosing lesions, while hypertension favours occlusive lesions. Conclusion: arterial lesions in ischemic stroke are intracranial, and extracranial, hence the need to couple transcranial Doppler with Doppler ultrasound of cervical vessels.
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