Objectives: Intracranial atherosclerosis has been suggested to be common in Asians. We apply a semi-quantitative CT scoring system to evaluate the degree of intracranial atherosclerotic calcification and determine its distribution, severity, and the associated risk factors. The clinical outcome of these patients after a 3-year follow-up was also evaluated.
Methods: Sixty consecutive patients diagnosed clinically to have either a transient ischemic attack (TIA) or minor ischemic stroke and underwent early computed tomographic angiography (CTA) were included into the prospective study. Two radiologists evaluated the axial CTA images for any calcification in the precavernous, cavernous and postcavernous segments of intracranial internal carotid artery (ICA), anterior, middle, and posterior cerebral as well as vertebrobasilar arteries, based on a standard CT scoring system for extent (0-4) and thickness (0-4). The composite CT score for extent and thickness of these vascular segments or vessels were recorded for all patients. The worst site (highest composite score) was chosen as the marker of the degree of intracranial atherosclerosis of each patient. The patients were then classified into mild, moderate, and severe groups, according to a composite CT score of 0-2, 3-5, and 6-8, respectively. These findings were gathered with clinical parameters and outcome after a 3-year follow-up period and corresponding statistical analyses were conducted.
Results: The most severely affected vessel was found to be intracranial internal carotid arteries, and severe, moderate, and mild atherosclerosis were present in 16 (26.67%), 30 (50%), and 14 (23.33%) patients, respectively. Using multiple logistic regression analysis, diabetes mellitus (odds ratio = 10.6, P value = .004), and age (odds ratio = 1.07, P value = .02) were found to be significant risk factors for severe intracranial atherosclerosis. Two patients in the severe group, 3 patients in the moderate group, and 1 patient in the mild group were found to have stroke or TIA after a 3-year follow-up, but there was no significant difference among the 3 groups.
Conclusion: Significant intracranial atherosclerosis as determined by severe CT calcification was common in a cohort of Chinese patients with TIA and minor stroke. Age and diabetes mellitus were independent significant risk factors, and this CT calcification score might serve as an early indicator of intracranial atherosclerotic disease.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.011 | DOI Listing |
Stroke
December 2024
Department of Neurosurgery and Interventional Neuroradiology, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, National Center for Neurological Disorders, Beijing, China. (L.J.).
Background: Previous trials have failed to demonstrate the benefits of extracranial-intracranial (EC-IC) bypass surgery for patients with carotid or middle cerebral artery occlusion. However, little evidence has focused on the effect of age on prognosis. This study aimed to explore whether EC-IC bypass surgery can provide greater benefits than medical therapy alone in specific age groups.
View Article and Find Full Text PDFNeurol Sci
December 2024
Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, Hokkaido, 060-8570, Japan.
Spontaneous thrombosis of intracranial aneurysms is rare. Spontaneous regression of unruptured small saccular aneurysms is even more rare. A 76-year-old woman with a history of hypertension and dyslipidemia was referred for evaluation of an unruptured intracranial aneurysm.
View Article and Find Full Text PDFJ Atheroscler Thromb
December 2024
Department of Neurology, Juntendo University Urayasu Hospital.
Aims: Atherogenic dyslipidemia (AD) is regarded as a residual risk of cardiovascular diseases characterized by low high-density lipoprotein cholesterol (HDL-C) and high triglyceride (TG) levels and related to the intracranial stenosis of atheromatous thrombotic brain infarction (ATBI). Further, atherosclerosis is possibly related to another stroke subtype, including cryptogenic stroke (CS). In particular, an aortic complicated lesion (ACL) is a notable embolic source of CS, since recurrence of aortogenic brain embolism is not rare.
View Article and Find Full Text PDFJ Inflamm Res
December 2024
Department of Neurology, Liaocheng People's Hospital, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
Background: Plaque enhancement is a non-specific marker of local inflammatory response, which may offer additional insights together with circulating inflammatory markers. Few studies have analyzed the association between intracranial atherosclerotic stenosis (ICAS) plaque enhancement and circulating inflammatory markers. Given the age-related variability in the progression of ICAS, this study aims to explore the association between the two across different age groups.
View Article and Find Full Text PDFEur J Neurol
January 2025
Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Background: Microembolic signals (MES) can be detected using transcranial Doppler (TCD) ultrasound in several clinical scenarios, including acute ischemic stroke (AIS). This narrative review aims to provide insights into their role in AIS patient management and outcomes.
Methods: The present narrative review consolidates current observational and randomized evidence on the prevalence and clinical relevance of MES in different AIS subtypes and settings.
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