Microembolic Signals Detected by Transcranial Doppler Predict Future Stroke and Poor Outcomes

Alvin S. Das, Robert W. Regenhardt, Sarah LaRose, Andrew D. Monk, Pedro M. Castro, Faheem G. Sheriff, Farzaneh A. Sorond, Henrikas Vaitkevicius*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


BACKGROUND AND PURPOSE: Although transcranial Doppler detects microembolic signals (MES) in numerous settings, the practical significance of such findings remains unclear. METHODS: Clinical information from ischemic stroke or transient ischemic attack patients (n = 248) who underwent embolic monitoring from January 2015 to December 2018 was obtained. RESULTS: MES were found in 15% of studies and ischemic recurrence was seen in 11% of patients (over 7 ± 6 days). Patients with MES had more lacunes than those without MES (1 ± 3 vs. 1 ± 2, P =.016), were more likely to have ischemic recurrence (37% vs. 6%, P <.001), undergo a future revascularization procedure (26% vs. 10%, P =.005), have a longer length of stay (9 vs. 4 days, P =.043), and have worse functional disability at discharge (modified Rankin Scale 3-6, 66% vs. 34%, P <.001). After controlling for several relevant cofactors, patients with MES were more likely to have ischemic recurrence (HR 4.90, 95% CI 2.16-11.09, P <.001), worse functional disability (OR 3.31, 95% CI 1.22-8.99, P =.019), and longer length of stays (β =.202, P <.001). CONCLUSIONS: MES may help to risk stratify patients as their presence is associated with ischemic recurrence and worse outcomes.

Original languageEnglish (US)
Pages (from-to)882-889
Number of pages8
JournalJournal of Neuroimaging
Issue number6
StatePublished - Nov 1 2020


  • Neurosonology
  • cerebral emboli
  • recurrence
  • stroke
  • transcranial Doppler sonography

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging


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