Mohamed Khalil¹, Ahmed El-Sadek², Diaa Mostafa³, Asmaa Ibrahem⁴, Ahmed Ebied⁵, Asmaa Elballat⁶ and Tarek Youssif⁷*

¹Specialist, Neurology Department, Phoenix Hospital, Abu Dhabi, UAE
²Assistant Professor, Neurology Department, Ain Shams University Cairo Egypt
³Specialist, Neurology Department, SEHA, Abu Dhabi, UAE
⁴Specialist, Neurology Department, Al-Raml Hospital Alexandria Egypt
⁵Lecturer, Neurology Department Faculty of medicine zagazig university, Egypt
⁶Specialist, Department of Neurology HMS garhoud hospital- Dubai- UAE
⁷Specialist, Neurology Department, Burjeel Holdings, Abu Dhabi, UAE

*Corresponding Author: Tarek Youssif, Specialist, Neurology Department, Burjeel Holdings, Abu Dhabi, UAE.

Received: July 27, 2024; Published: August 29, 2024

Abstract

This study aimed to assess the Pulsatility index value as possible significant predictor of functional outcome among acute ischemic stroke patients who received intravenous thrombolytic therapy.

Patient and Methods: this is a case series report involved three cases from three different centers in Egypt and UAE, those patients had acute ischemic stroke and received intravenous thrombolytic therapy as per guidelines and they were followed up over a period of three months.

Results: in those patients the Pulsatility index value of same side of the lesion were assessed and correlated with their functional outcome using modified rankin scale and showed that the functional outcome was poor when PI value was increased.

Conclusion: PI value in the cerebral vessels at same side of stroke lesion is a promising significant predictor of functional outcome in patients with acute ischemic stroke who received thrombolytic therapy. Thus, we recommend further large studies involving large number of patients and explore it as a possible significant independent predictor of functional outcome.

 Keywords: Pulsatility Index; Acute Ischemic Stroke; TCD

References

1. Donnan GA., et al. “American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2015 update: a report from the American Heart Association”. Circulation4 (2015): e229-322.
2. Lee KO., et al. “Lacunar infarction in type 2 diabetes is associated with an elevated intracranial arterial Pulsatility index”. Yonsei Medical Journal 48 (2007): 802-806.
3. Webb AJ., et al. “Increased cerebral arterial Pulsatility in patients with leukoaraiosis: arterial stiffness enhances transmission of aortic Pulsatility”. Stroke 43 (2012): 2631.
4. Lee KY., et al. “Arterial Pulsatility as an index of cerebral microangiopathy in diabetes”. Stroke 31 (2000): 1111-1115.
5. Leonards CO., et al. “White matter lesion severity in mild acute ischemic stroke patients and functional outcome after 1 year”. Stroke 43 (2012): 3046-3051.
6. Marián M., et al. “Baseline National Institutes of Health Stroke Scale-Adjusted Time Window for Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke”. Stroke 45 (2014): 1059-1063.
7. Banks JL and Marotta CA. “Outcomes validity and reliability of the modified rankin scale: implications for stroke clinical trials-a literature review and synthesis”. Stroke 3 (2007): 1091-1096.
8. Wahlgren N., et al. “Thrombolysis with alteplase for acute ischaemic stroke in the safe implementation of thrombolysis in stroke monitoring study (SITS-MOST): an observational study”. Lancet9558 (2007): 275-282.
9. Kim JY., et al. “Central aortic pressure and Pulsatility index in acute ischemic stroke”. Journal of Neuroimaging 25 (2015): 438-442.
10. Huang YC., et al. “Hemodynamic factors may play a critical role in neurological deterioration occurring within 72 hrs after lacunar stroke”. PLoS One 9 (2014):
11. Tarumi T., et al. “Cerebral hemodynamics in normal aging: central artery stiffness, wave reflection, and pressure Pulsatility”. Journal of Cerebral Blood Flow and Metabolism 34 (2014): 971-978.
12. Wakerley BR., et al. “Usefulness of transcranial Doppler-derived cerebral hemodynamic parameters in the non-invasive assessment of intracranial pressure”. Journal of Neuroimaging 25 (2015): 111-116.
13. Yemisci M., et al. “Pericyte contraction induced by oxidative-nitrative stress impairs capillary reflow despite successful opening of an occluded cerebral artery”. Nature Medicine9 (2009): 1031-1037.
14. Gursoy-Ozdemir Y., et al. “Microvascular protection is essential for successful neuroprotection in stroke”. Journal of Neurochemistry2 (2012): 2-11.
15. Nevzat U., et al. “Relationship between Pulsatility Index and Clinical Course of Acute Ischemic Stroke after Thrombolytic Treatment”. BioMed Research International (2013): 5.
16. Kim Y., et al. “The Effect of Pulsatility Index on Infarct Volume in Acute Lacunar Stroke”. Yonsei Medical Journal 4 (2016): 950-955.

Citation

Citation: Tarek Youssif., et al. “Correlation Between Pulsatility Index and Functional Outcome Post-Intravenous Thrombolytic Therapy in Acute Ischemic Stroke; Multi-Centers Cases”. Acta Scientific Neurology 7.9 (2024): 15-20.

Copyright

Copyright: © 2024 Tarek Youssif., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.