Early screening of individuals considered to be at risk for severe internal carotid artery (ICA) stenosis is an important strategy for preventing ischemic cerebral stroke. The purpose of this study is to screening candidate single nucleotide polymorphisms (SNPs) associated with severe ICA stenosis using a newly developed oligonucleotide-based custom DNA array. The subjects consisted of 47 controls and 46 patients with severe ICA stenosis (≥70%) who underwent carotid endarterectomy (CEA). Subjects gave informed consent and we obtained samples of blood and genomic DNA. We studied 8 candidate genes: renin-angiotensin system [angiotensinogen (AGT), angiotensin II receptor type 1 (AGTR1), nitric oxide synthase 3 (NOS3)]; growth factor [hepatocyte growth factor (HGF)]; transgelin (SM22); cytokine [chemokine receptor 2 (CCR2)]; coagulation-fibrinolysis system [5,10-methylenetetrahydrofolate reductase (MTHFR)]; and plasminogen activator inhibitor 1 (PAI-1). Genotyping of candidate SNPs was done with a line probe assay (LiPA) based on an oligonucleotide-based DNA array. Results: The allele frequency of PAI-1 –1965 delG (odds ratio (OR), 0.3; 95% confidence interval (CI), 0.2–0.6) and MTHFR (OR 1.3, 95% CI, 1.0–1.5) were significantly different between controls and cases with ICA stenosis by Fisher’s exact test. Multiple logistic analysis revealed that diabetes mellitus (DM), SNPs in PAI-1 –1965 delG and MTHFR were an independent risk for ICA stenosis. In conclusion, genetic factors of coagulation-fibrinolysis as well as diabetes mellitus (DM) were relevant in ICA stenosis.
Acase of acute spontaneous subdural hematoma with angiographic extravasation of contrast medium is reported . A56 − year − old man was admitted because he experienced a sudden severe headache , vomiting and a distur − bance of consciousness while washing his car . He had no experience of head injury . On admission , computed tomo − graphy ( CT )revealed an acute subdural hematoma in the right temporoparietal region . Cerebral angiography showed an extravasation of contrast medium from a branch of the angular artery at the edge of the hematoma . After these examinations , the hematoma volume showed no further enlargement and his neurological symptoms improved. Therefore , he was observed under conservative therapy Twenty days after onset , hematoma evacuation with right craniotomy was perfbrmed because he complained of a headache and his CT demonstrated chronic sub − dural hematoma . During operation , bleeding from the cortical branch of the angular artery was found and it was coagulated . He was discharged after 37 days without any neurological de丘ciし The characteristic features of acute spontaneous subdural hernatoma were retrospectively investigated in the literatures . Acute subdural hematoma with an unknown history of head injury should be treated in consideration of possible spontaneous subdural hematoma , (
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