Mechanism of ischemic infarct in spontaneous carotid dissection.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_DAC6A7CC9868
Type
Article: article from journal or magazin.
Collection
Publications
Title
Mechanism of ischemic infarct in spontaneous carotid dissection.
Journal
Stroke
Author(s)
Benninger D.H., Georgiadis D., Kremer C., Studer A., Nedeltchev K., Baumgartner R.W.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
35
Number
2
Pages
482-485
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND AND PURPOSE: It is unclear whether stroke in patients with spontaneous dissection of the cervical internal carotid artery (ICAD) is due to thromboembolism or impaired hemodynamics. This study investigated the mechanism of stroke in ICAD by examining brain imaging and cerebrovascular findings of such patients.
METHODS: We retrospectively evaluated the prospectively collected brain CT, MR, and ultrasound findings of 141 consecutive patients with 143 ICADs causing ischemic stroke. Eleven patients were not included because they had an inappropriate temporal bone window (n=6) or were treated with thrombolysis (n=5). Thus, the data of 130 patients (76 men, 54 women) with 131 ICADs were analyzed.
RESULTS: All patients had territorial infarcts; 6 patients (5%) also had border-zone infarct patterns. Territorial infarcts affected the middle cerebral artery (MCA) in 130 of 131 cases (99%) and the anterior cerebral artery (ACA) in 1 case (1%). Additional vascular territories were affected in 8 patients with MCA infarcts (ACA, n=5 [4%]; posterior cerebral artery, n=3 [2%]). The pattern (hemodynamic versus thromboembolic) and extent of infarction were not influenced by vascular findings (MCA stenosis or occlusion, ACA occlusion, degree of obstruction in the dissected ICA, pattern of cross-flow in 115 patients with >80% ICA stenosis or occlusion).
CONCLUSIONS: This study suggests that thromboembolism, not hemodynamic infarction, is the essential stroke mechanism in ICAD.
Keywords
Brain Ischemia/diagnosis, Brain Ischemia/etiology, Carotid Artery Thrombosis/complications, Carotid Artery Thrombosis/diagnosis, Carotid Artery, Internal/radiography, Carotid Artery, Internal/ultrasonography, Carotid Artery, Internal, Dissection/complications, Carotid Artery, Internal, Dissection/radiography, Cerebral Infarction/classification, Cerebral Infarction/diagnosis, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Risk Factors, Tomography, X-Ray Computed
Pubmed
Web of science
Open Access
Yes
Create date
08/10/2012 10:24
Last modification date
20/08/2019 16:59
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