Ischemic Stroke Clinical Trial
Official title:
Norwegian Microemboli in Acute Stroke Study (NOR-MASS)
BACKGROUND: The cause of ischemic stroke remains undetermined in 30-40% of the cases, but
circulating blood clots (thromboemboli) are a postulated common denominator in approx. 75% of
patients. Transcranial Doppler monitoring (TCDM) is a non-invasive method of detecting
circulating microemboli (CME) in the human cerebral circulation. The method is not used
systematically in unselected groups of patients with repeated long-term registrations. New
ultrasound equipment is ambulatory, less unpleasant for the patient and allows extended
monitoring sessions. This may vastly simplify the implementation of TCDM as a clinically
useful diagnostic tool.
AIMS: Determine the usefulness of TCDM in acute stroke diagnostics by assessing prevalence
and frequency of CME in unselected patients with ischemic stroke, the influence of
antithrombotic drugs on CME and the relationship between MES and recurrent stroke or
transient ischemic attack (TIA).
HYPOTHESES: Prevalence and frequency of CME are higher during the first 24 hours than at
later follow-up. Stroke etiology can be assessed by the presence or absence of CME. Presence
of CME is associated with increased risk of recurrent TIA of stroke within 3 months and 1
year. Cessation of CME after the start of antithrombotic treatment is associated with reduced
risk of recurrent TIA or stroke.
- Standardized questionnaire
- Clinical work-up in accordance with hospital standard operating procedures, i.e.
radiological and cardiological procedures, neurovascular ultrasound, clinical scoring,
etc.
- 1st Transcranial Doppler monitoring (TCDM) at admission if within 24 hours after stroke
onset (day 1). TCDM is repeated at 18-36 hours and at day 3. Microembolic signals are
automatically registered by the software and subsequently verified manually.
;
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