scholarly journals Evaluation of Extracranial Carotid Arteries in Ischemic Stroke Patients Using Color Doppler Sonography and Correlation with Various Risk Factors

2019 ◽  
Vol 8 (2) ◽  
pp. 10-14
Author(s):  
Manish Raj Pathak ◽  
Mahesh Gautam ◽  
Yagya Raj Pathak

Background: Cerebral ischemic stroke is the major cause of death after ischemic heart disease and malignancies, among which major cases of stroke results from atherosclerosis of intra and extra-cranial carotid vessels. The aim of this study is to evaluate the extracranial carotid arteries in patients with ischemic stroke and correlation with various risk factors. Materials and Methods: A cross sectional study of the patients with ischemic stroke presented in Radiology department of Nobel Medical College were evaluated for a period of one year from February 2017- January 2018 using color Doppler ultrasound and correlated with various risk factors. A total of 50 patients were included in the study. All age groups and sex were included. Results: Out of 50 patients, 29 patients (58%) were males and 21 patients (42%) were females. Stroke was present in 24 patients on right side and 26 patients on left side. A total of 36 patients had extra-cranial carotid stenosis. Among them, 18 patients had <50% stenosis, 17 patients had >50% stenosis and 1 patient had complete occlusion. The most common cause of obstruction was found to be atherosclerotic changes in the form of atheromatous plaque. Out of 50 patients 27 had history of hypertension and 19 had history of smoking. Out of 27 hypertensive patients, 23 had stenosis which is statistically significant (p value 0.024).    Conclusion: The current study shows the importance of color Doppler ultrasound as an economic, safe and non-invasive method of demonstrating the cause of stroke in extra-cranial carotid artery system

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.


2021 ◽  
Author(s):  
Chatpol Samuthpongtorn ◽  
Tul Jereerat ◽  
Nijasri Suwanwela

Abstract Background: Nowadays, the number of elderly has steadily increased annually. Elderly patients with ischemic stroke often have worse outcomes than younger patients. However, there has not been a study of ischemic stroke in the elderly in Thailand. A better knowledge of the risk factors, subtypes, and outcomes of strokes in the elderly may have significant practical implications for the aged society in the future. The objective of the study was to assess the risk factor, stroke subtypes, and outcome of stroke in the elderly compared to the younger patients.Method: All patients presented with acute ischemic stroke and transient ischemic attack (TIA) aged over 45 years who were admitted in the Stroke unit between November 1st, 2016 and December 31st, 2017 were retrospectively studied.Result: 542 patients were included. The average age was 68.78±12.03, 44.8% of them were male. 186 (34.3%) patients were 75 or older. Cardioembolism was found to be the most common cause of ischemic stroke in 156 patients (28.8%). Patients who were 75 or older had significantly worse outcomes in all categories including NIHSS at discharge, modified Rankin scale, length of stay and the number of deaths) compared to the younger group. Atrial fibrillation was the risk factors associated with older age with OR 3.861 (p value<0.001). Aged 75 years or older, atrial fibrillation, more NIHSS score on admission and history of the previous stroke were the risk factors associated with a patient's death.Conclusion: The elderly who are 75 years or older accounts for more than one-third of ischemic stroke in our study. Stroke in the elderly correlates with higher mortality and poorer outcome. Cardioembolism related to atrial fibrillation is the major cause of stroke in this population.


2017 ◽  
Vol 24 (08) ◽  
pp. 1126-1131
Author(s):  
Muhammad Ishaq Khattak ◽  
Faramoz Khan ◽  
Zahid Fida ◽  
Adnan Zar

Objectives: The objective of this study is to determine the frequency of carotidartery atherosclerosis using color Doppler ultrasound in ischemic stroke patients. StudyDesign: Cross-sectional study. Period: July 2015 to June 2016. Setting: Khyber TeachingHospital, Peshawar. Method: Doppler ultrasonography was done to assess carotid artery statusin patients diagnosed with cerebral infarction. Results: Data comprised of 174 ischemic strokepatients between ages 37-95 years. 111 were males whereas 63 were males. Mean age wasfound to be 64.03±11.71 years. Doppler ultrasound revealed carotid artery atherosclerosis in52.3% (n=91) patients with 57% males and 34% females. Right carotid artery involvement wasfound in 28 patients and left carotid artery involvment in 38 patients. Both carotid arteries wereinvolved in 25 patients. Conclusion: We have concluded that carotid artery atherosclerosis is anindependent predictor for future vascular events. Our study reports carotif artery atherosclerosisin 52.3% patients with ischemic stroke.


2019 ◽  
Vol 12 (1) ◽  
pp. 140
Author(s):  
Ulfiawaty Ulfiawaty ◽  
Bachtiar Murtala ◽  
Mirna Muis

Limfadenopati didefinisikan sebagai sebuah abnormalitas ukuran dan konsistensi dari limfonodus yang bisa terjadi akibat proses infeksi dan inflamasi lainnya. Penelitian ini bertujuan menjelaskan nilai diagnostik USG color Doppler dan Elastografi dalam menentukan limfadenopati leher jinak dan ganas dibandingkan dengan hasil Bajah. Penelitian ini dilaksanakan di Bagian Radiologi RS Universitas Hasanuddin, Makassar yang dimulai pada bulan Februari-Maret 2018. Desain penelitian menggunakan uji diagnostik. Sebanyak 50 sampel dengan klinis limfadenopati leher. Dilakukan pemeriksaan ultrasonografi color Doppler untuk melihat pola, lokasi vascular serta nilai resistive index, kemudian dilakukan elastografi untuk menentukan elastisitas jaringan. Dilanjutkan dengan melakukan pemeriksaan Bajah untuk menentukan limfadenopati leher jinak dan ganas sete. Analisis data menggunakan statistik melalui uji diagnostik. Hasil penelitian menunjukkan bahwa dari uji diagnostik, didapatkan pola vaskuler memiliki sensitivitas 72%, spesifitas 92%, akurasi 84%, NPP 88%, NPN 81%. Lokasi vaskuler memiliki sensitivitas 59%, spesifitas 86%, akurasi 80%, NPP 92%, NPN 75%. Nilai resistive indeks didapatkan cut 0ff 0,795 dengan nilai sensitivitas 95,5%, spesifitas 75%, akurasu 84%, NPP 75% dan NPN 95,5%. Apabila dibandingkan dengan USG color Doppler dan elastografi, maka elastografi jauh lebih unggul dalam menentukan limfadenopati leher jinak dan ganas dengan sensitivitas 95,4%, spesifitas 96,4%, akurasi 96%, nilai prediksi positif 95,4% dan nilai prediksi negatif 96,4%.   Lymphadenopathy is defined as an abnormality in the size and consistency of the lymph nodes that can occur due to other infections and inflammatory processes. This study aimed to determine the diagnostic value of ultrasound color Doppler and Elastography in determining the benign and malignant cervical lymphadenopathy compared with the results of the elephant Research method. This research was conducted in Radiology Department of Hasanuddin University Hospital, Makassar which started in February-March 2018. The research design used the diagnostic test. A total of 50 samples with clinical cervical lymphadenopathy. The color Doppler ultrasound examination was conducted to find out the pattern, vascular location and resistive index value, then the elastography was performed to determine the elasticity of the tissue. After that, a FNA examination was done to determine benign and malignant cervical lymphadenopathy. The data analysis used the statistic through the diagnostic tests. The research results indicated that the diagnostic test revealed the vascular pattern of 72% sensitivity, 92% specificity, 84% accuracy, NPP 88%, NPN 81%. The vascular site had a sensitivity of 59%, specificity 96%, accuracy of 80%, NPP of 92%, NPN of 75%. The resistive values index obtained 0ff 0.795 with 95.5% sensitivity, 75% specificity, 84% accuracy, 75% NPP, and 95.5% NPN. When compared with Doppler ultrasound and elastography, the elastography was superior in determining benign and malignant cervical lymphadenopathy with 95.4% sensitivity, 96.4% specificity, 96% accuracy, 95.4% NPP and NPN of 96.4 %. Thus, Doppler ultrasound and elastography had high diagnostic values, which could be used to determine both benign and malignant cervical lymphadenopathy.


2021 ◽  
Vol 11 (1) ◽  
pp. 168-173
Author(s):  
Qiongyan Dai ◽  
Yun Wang

Objective: To observe the early changes of uterine incision defects after cesarean section by transvaginal color Doppler ultrasound, and to analyze the risk factors of their formation. Methods: A total of 181 women who underwent cesarean section from September 2016 to June 2018 and who underwent transvaginal ultrasound examination at 6 weeks, 3 months, and 6 months after birth were divided into two groups. (142 cases) and incision defect group (39 cases). The incision changes and the risk factors of incision defect in different periods of postpartum were analyzed. Results: Compared with the group with good incision healing, the length of the incision defect in the cesarean section at 6 months after delivery was shorter than that at 6 weeks after delivery (P < 0.05). The results of non-conditional logistic regression showed that the number of cesarean sections increased and the number of operators was lower. Seniority, postoperative infection, posterior uterine position, and incision close to the cervix are risk factors for poor healing of uterine scars. Conclusion: As the postpartum time increases, the length of the cesarean section incision defect shortens; multiple cesarean sections, puerperal infections, posterior uterus, low incision position and inexperience of the operator are the risk factors for the formation of uterine incision defects and increase uterine scars. Risk of poor healing.


2021 ◽  
Vol 15 (10) ◽  
pp. 3304-3306
Author(s):  
Saba Akram ◽  
Aasma Ashraf ◽  
Zainab Zahur ◽  
Aniqua Saleem ◽  
Safia Ashraf ◽  
...  

Background: Ovarian cysts known as ovarian masses, are commonly found incidentally in asymptomatic women. Ovarian cancer is the 7th most frequent cancer in women worldwide, as well as the eighth leading cause of cancer death. Ultrasonography is the principal imaging technique for confirming the mass ovarian origin and determining whether the mass is benign or malignant. Method: This descriptive cross sectional study was conducted from 15 June to December 2019 in the Radiology Department of Avicenna Medical College. A total of 90 ultrasounds undertaken at the Gynecological Ultrasound Unit. A total of 32 patients with functioning ovarian cysts were included. A total of 46 individuals with benign tumors and 9 patients with malignant cysts were included in the control group. The remaining patients were not followed up on and were treated at a different center. The majority of the patients had issues with their menstrual cycle and pain. Results: The mean age of the patients was 35.6+9.16. In functioning ovarian cysts, benign tumors & ovarian tumors. The functioning ovarian cysts had a mean size of 40.8 mm +16.35 mm. Differences were significant found between1this group & other1two groups: A mean size of 61.75 +65.5; P, 0.001 was seen for non-functional benign ovarian disease; and the average size of malignant cysts was 85.9 +50.6; P = 0.001. Out of 32 functional1ovarian cysts, 22 were found by ultrasonography, 8.0 were not identified and 2.0 cases were1diagnosed ultra-sonographically as functional ovarian cysts but histologically revealed to be benign ovarian cysts (non-functional). The sensitivity of color Doppler ultrasound was determined to be 82.0%. Conclusion: The study's findings revealed that ultrasound had an 82 percent sensitivity in diagnosing ovarian masses, increasing its accuracy. As a result, ultrasonography appears to be the first modality of choice in the examination of any woman suspected of having an ovarian tumor. Also, to rule out the need for unnecessarily surgical procedures in benign lesions. Keywords: Ovarian Cysts, cancer, ultrasound


2017 ◽  
Vol 107 (3) ◽  
pp. 253-256 ◽  
Author(s):  
Mariana Pizarro ◽  
Nicolás Pieressa ◽  
Ximena Wortsman

Retronychia, the posterior embedding of the nail bed into the proximal nail fold, can be a complex clinical dermatologic diagnosis that may mimic other inflammatory ungual diseases or tumors of the nail. It has been related to a history of severe systemic conditions that secondarily affect the nail matrix and is commonly associated with onychomadesis. We present a case of retronychia of the foot with a purely traumatic origin, nonconcomitant with onychomadesis, that was diagnosed by color Doppler ultrasound in a long-time practitioner of martial arts who was otherwise healthy. Color Doppler ultrasound is an excellent imaging technique for supporting the diagnosis of retronychia. It provides information on the exact location and morphology of the nail plate as well as the presence of inflammatory signs in the ungual and proximal periungual regions. Additionally, this imaging technique can support the differential diagnosis with other nail conditions. Since there are many sports or activities that can potentially injure the toenails, retronychia may be an underestimated entity and the present case can raise the awareness of this condition and show the usefulness of color Doppler ultrasound.


2020 ◽  
Vol 3 (3) ◽  
pp. 129
Author(s):  
Hendri Budi ◽  
Indrawati Bahar ◽  
Heppi Sasmita

ABSTRAKTujuan: mengetahui faktor risiko yang menyebabkan stroke hemoragik dan iskemik pada pasien usia produktif di RSSN Bukittinggi. Metode: Jenis penelitian ini deskriptif observasional dengan desain cross sectional. Penelitian dilaksanakan di RSSN Bukittinggi pada April sampai Oktober 2015. Populasinya seluruh pasien stroke yang dirawat di ruangan saraf berjumlah 2.132 pasien. Sampel berjumlah 77 orang yang memenuhi kriteria inklusi, dipilih dengan cara purposive sampling. Pengumpulan data menggunakan studi dokumentasi. Instrumen menggunakan daftar checklist tentang faktor risiko stroke yang dapat dimiliki pasien. Analisis data menggunakan statistik deskriptif, uji t independent, chi square dan multivariate regresi logistik. Hasil penelitian: 58,4% pasien stroke berjenis kelamin laki-laki; 97,4% berumur dewasa tua (36-59 tahun), 28,6% pekerjaan ibu rumah tangga; 68,8% stroke iskemik, 13,2% diantaranya berusia 21-45 tahun; 39,6% berusia 56-59 tahun; 31,2% stroke hemoragik, 29,2% diantaranya berusia 21-45 tahun, 37,5% berusia 51-55 tahun. Faktor risiko yang berhubungan dengan stroke iskemik yaitu hipertensi (p value=0,012), kurang olah raga (p value=0,008), dan pola makan banyak lemak (p value=0,029). Faktor yang paling berpengaruh adalah hipertensi (p value=0,052). Faktor risiko yang berhubungan dengan stroke hemoragik yaitu hipertensi (p value=0,016). Kesimpulan: Pada pasien usia produktif, stroke iskemik disebabkan oleh riwayat hipertensi, kurang olah raga dan pola makan banyak lemak, dan faktor yang paling berpengaruh yaitu riwayat kurang olah raga, sedangkan stroke hemoragik disebabkan oleh adanya riwayat hipertensi. Disarankan kepada manajemen perawatan dan perawat agar melaksanakan pendidikan kesehatan yang berfokus pada penatalaksanaan pasien hipertensi, modifiasi gaya hidup dan discharge planning terkait faktor risiko stroke kepada pasien dan keluarga.Kata Kunci: Faktor risiko, stroke iskemik, stroke hemoragikRisk Factors of Stroke in Productive Age at National Stroke Hospital (Rssn) Bukit Tinggi ABSTRACT Objective: to determine the risk factors that cause hemorrhagic and ischemic strokes in productive age patients at RSSN Bukittinggi. Method: Type of research was observational descriptive with crosssectional design. The study was conducted at RSSN Bukittinggi on April to October 2015. The population was all stroke patients treated in the nerve ward totaling 2,132 patients. Samples were 77 people who met the inclusion criteria obtained by purposive sampling. Data collection used documentation study. The instrument is a checklist of stroke risk factors that a patient could have. Data analysis using descriptive statistics, independent t test and chi square test and multivariate logistic regression. Results: 58.4% of stroke patients were male, 97.4% were elderly adults (36-59 years), 28.6% were housewives, 68.8% of ischemic strokes 13.2% were aged 21 -45 years, 39.6% were 56 -59 years. 31.2% of hemorrhagic strokes 29.2% of them aged 21-45 years, 37.5% aged 51-55 years. Risk factors associated with ischemic stroke are hypertension (p value:0.012), lack of exercise (p value:0.008), and eating a lot of fat (p value:0.029). The most influential factor is hypertension (p value:0.052). Risk factors associated with hemorrhagic stroke are hypertension (p value:0.016). Conclusion: In patients of productive age, ischemic stroke is caused by a history of hypertension, lack of exercise and eating a lot of fat, and the most influential factor is a history of lack of exercise, whereas hemorrhagic stroke is caused by a history of hypertension. It is recommended to care management and nurses to carry out health education that focuses on the management of hypertensive patients, lifestyle modification and discharge planning related to stroke risk factors to patients and families. Keywords: Risk factors, ischemic stroke, hemorrhagic stroke


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