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Mechanism of ischemic infarct in spontaneous carotid dissection

Benninger, D H; Georgiadis, D; Kremer, Christine LU ; Studer, A; Nedeltchev, K and Baumgartner, R W (2004) In Stroke; a journal of cerebral circulation 35(2). p.482-482
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stroke, ultrasonography, dissection, diagnostic imaging, carotid artery, internal
in
Stroke; a journal of cerebral circulation
volume
35
issue
2
pages
482 - 482
publisher
American Heart Association
external identifiers
  • pmid:14757894
  • scopus:0842289197
ISSN
1524-4628
DOI
10.1161/01.STR.0000109766.27393.52
language
English
LU publication?
yes
id
26101d2d-2ba4-41af-8f80-25500b6d7f63 (old id 1130895)
date added to LUP
2008-06-19 10:40:06
date last changed
2017-12-10 04:38:48
@article{26101d2d-2ba4-41af-8f80-25500b6d7f63,
  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.},
  author       = {Benninger, D H and Georgiadis, D and Kremer, Christine and Studer, A and Nedeltchev, K and Baumgartner, R W},
  issn         = {1524-4628},
  keyword      = {stroke,ultrasonography,dissection,diagnostic imaging,carotid artery,internal},
  language     = {eng},
  number       = {2},
  pages        = {482--482},
  publisher    = {American Heart Association},
  series       = {Stroke; a journal of cerebral circulation},
  title        = {Mechanism of ischemic infarct in spontaneous carotid dissection},
  url          = {http://dx.doi.org/10.1161/01.STR.0000109766.27393.52},
  volume       = {35},
  year         = {2004},
}