ArticleEuropean journal of neurology2026
Clinical Significance of Microembolic Signal Detection in Acute Ischemic Stroke: Insights Into Ongoing Cerebral Embolization and Occult Etiologies.
Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Microembolic signals in transcranial Doppler and the functional outcome of patients with acute ischemic stroke: a meta-analysis.Frontiers in neurology · 2026Pooled it
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeTranscranial Doppler (TCD) detects microembolic signals (MES), reflecting ongoing cerebral embolization. MES have been studied across stroke subtypes and may clarify etiology, monitor treatment, and predict recurrence. We aimed to determine the prevalence of MES in acute ischemic stroke (AIS), explore clinical and laboratory associations, and assess their role in etiological workup.
methodsWe conducted a prospective single-center study over 3 years including anterior circulation AIS patients within 24 h of onset. Stroke subtype was classified by TOAST criteria. Bilateral middle cerebral artery TCD monitoring was performed for 30 min to detect and quantify MES.
resultsAmong 136 patients (mean age 60.1 ± 12.4 years), MES were detected in 22 (16.2%; 95% CI: 10.4%-23.5%). MES(+) patients had more often multiple-territory infarcts (36.4% vs. 10.5%, p = 0.005), newly detected atrial fibrillation (13.6% vs. 0.9%, p = 0.013), and cancer-associated stroke (18.2% vs. 0.9%, p = 0.002), whereas cryptogenic etiology was less common (18.2% vs. 41.2%, p = 0.041). MES were absent in lacunar stroke. MES positivity correlated with higher D-dimer levels (median 932 vs. 456 ng/mL, p < 0.001), and MES counts correlated strongly with D-dimer values (Spearman coefficient: 0.393, p < 0.001).
conclusionsMES were detected in one-sixth of anterior circulation AIS patients, but were absent in lacunar stroke. Their presence was associated with multiple-territory infarcts, newly detected atrial fibrillation, and cancer-related stroke. MES counts correlated with D-dimer levels, supporting their role as markers of ongoing cerebral embolization and underlying prothrombotic state, with potential utility in revealing occult embolic mechanisms.
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