In patients with acute cerebral infarction, taranscranial ultrasonography is helpful in assessing blood flow, but in some patients, failure to detect cerebral blood flow through the temporal window is an important problem in expansion of clinical indications for transcranial ultrasonography. This study was performed between May 2016 and September 2016 in patients admitted to the neurology department of Chosun University Hospital with cerebral infarction and underwent transcranial ultrasonography and brain magnetic resonance image. Of the 129 patients, 47 were female (36.4%). The mean age of the patients was 80.7±8.0 years. Fifty patients (38.8%) did not showed any blood flow signal due to poor temporal window. The mean age of patients with temporal window failure (83.8±6.0 years) was significantly higher than without temporal window failure (78.7±8.5), and the temporal window failure was significantly higher in women. In conclusion, temporal window failure was more common in elderly and women in this study. In addition to temporal bone thickness and heterogeneity of temporal bone due to osteoporosis, hyperlipidemia may also be associated with temporal window failure and future prospective studies will be needed.

Proportion of elderly patients is gradually increasing in the republic of Korea. However, intravenous recombinant tissue plasminogen activator (rt-PA) therapy is recently not recommended in elderly acute ischemic stroke patients, although old age is not a proven contraindication to intravenous rt-PA. The purpose of this study was to investigate the safety and prognosis of intravenous thrombolysis in elderly patients.