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Impact of Asymmetric Middle Cerebral Artery Velocity on Functional Recovery in Patients with Transient Ischemic Attack or Acute Ischemic Stroke
Korean J Clin Lab Sci 2018;50:126-135  
Published on June 30, 2018
Copyright © 2018 Korean Society for Clinical Laboratory Science.

Minho Han1, Hyo Suk Nam2

1Department of Neurology, Yonsei University College of Medicine, Department of Science for Aging, Yonsei University Graduate School, Seoul, Korea
2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Hyo Suk Nam
Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea Tel: 82-2-2228-1617 Fax: 82-2-393-0705 E-mail:
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)×100. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ≥3 at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2∼91.9] to 89.2% [95% CI, 85.9∼92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.
Keywords : Transcranial doppler ultrasonography, Middle cerebral artery, Asymmetry

June 2018, 50 (2)
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