Background: Microembolic signals (MES) are associated with the pathogenic mechanism of ischemic stroke with large-artery atherosclerotic disease. We examined the relationship between MES on a transcranial Doppler ultra-sonography (TCD) and lesion patterns on diffusion-weighted MR imaging (DWI) in acute ischemic strokes associated with atherosclerotic diseases of the middle cerebral artery (MCA) and internal carotid artery (ICA). Methods: A total of 405 consecutive patients were monitored for MES within 48 hours of symptom onset. Patients with MES and DWI lesions in the territory of the MCA or ICA and corresponding MCA/ICA stenosis or occlusion on MR angiography (MRA) were included. MCA velocities and lesion patterns on DWI were compared. Results: MES were detected in 25 patients (MCA: 13, ICA: 12). The mean number of MES during 30 minutes o
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