Carotid disease in acute stroke

Mead, Gillian; Shingler, Helen; Farrell, Anne G.; O’Neill, Paul; McCollum, Charles

doi:10.1093/ageing/27.6.677

Cited by 41 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[2][3][4][5] Carotid disease and cardiac sources of emboli are more common in total and partial anterior circulation infarcts (TACIs and PACIs, respectively) than in lacunar (LACIs) and posterior circulation infarcts (POCIs). 6,7 While numerous studies have examined intracranial arterial velocities in middle cerebral artery (MCA) stroke, 8 -13 only 2 (of 32 and 85 patients, respectively) have investigated the relationship between the OCSP classification and patterns of vascular occlusion. 14,15 Both demonstrated that those with TACIs were more likely than the other subtypes to have occlusion of the MCA, and those with LACIs were unlikely to have intracranial large-vessel disease.…”

mentioning

confidence: 99%

Relationship Between Pattern of Intracranial Artery Abnormalities on Transcranial Doppler and Oxfordshire Community Stroke Project Clinical Classification of Ischemic Stroke

Mead

Wardlaw²,

Dennis³

et al. 2000

Stroke

View full text Add to dashboard Cite

Background and Purpose-The Oxfordshire Community Stroke Project (OCSP) devised a simple classification for acute stroke based on clinical features only, which is of value in predicting prognosis. We investigated whether the pattern of intracranial vascular abnormalities is related to the clinical syndrome. Methods-Patients with acute ischemic stroke were classified by a stroke physician as having total or partial anterior circulation infarct (TACI or PACI, respectively), lacunar infarct (LACI), or posterior circulation infarct (POCI

show abstract

mentioning

confidence: 99%

Relationship Between Pattern of Intracranial Artery Abnormalities on Transcranial Doppler and Oxfordshire Community Stroke Project Clinical Classification of Ischemic Stroke

Mead

Wardlaw²,

Dennis³

et al. 2000

Stroke

View full text Add to dashboard Cite

show abstract

“…The prevalence of significant stenosis in studies conducted in Western population was about 14% (2) and 21%. (3) This variation could be due to racial differences. (4,5) Extracranial carotid artery stenosis was more commoner in whites and men.…”

Section: Discussionmentioning

confidence: 99%

“…3 Carotid ultrasonography combines B mode ultrasound image with a doppler ultrasound assessment of blood flow velocity. These plaques alter the blood flow haemodynamics and increase the systolic flow velocity.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Carotid Artery Stenosis in Stroke/Transient Ischaemic Attack

Subramanyam¹,

P²,

Vakrani³

2015

jemds

View full text Add to dashboard Cite

BACKGROUND: Stroke remains the second leading cause of death worldwide, after ischaemic heart disease. Patients with carotid artery stenosis are at higher risk of development of stroke. Carotid atherosclerosis occurs in patients with atherosclerotic risk factors like diabetes mellitus, hypertension, smoking and hyperlipidemia. Carotid artery stenosis can be assessed by means of noninvasive high-resolution B-mode ultrasonography of the carotid arteries. AIMS AND OBJECTIVES: 1). To estimate the prevalence of carotid artery stenosis in ischaemic stroke/transient ishaemic attack patients. 2). To estimate whether there was any association between carotid artery stenosis and important risk factors such as diabetes mellitus, hypertension, hyper lipidemia with control group. METHODS AND MATERIALS: Acute ischaemic/TIA stroke patients with CT-Brain showing infarcts were enrolled for the study. All patients were subjected to CT scan brain study and colour Doppler study of extracranial carotid arteries. The systolic and diastolic velocity of blood flow, and the ratio of peak systolic velocities of common carotid arteries were assessed. RESULTS: DM, HTN, Smoking & Hyperlipidemia acted as risk factors for carotid stenosis. The prevalence of carotid stenosis in our study was 60%. The prevalence of mild, moderate and severe stenosis were 34%, 10% and 16% respectively. The distribution of carotid stenosis was equal on both sides. The statistical significance was calculated using Chi-square test. Statistical significance was taken when P value was <0.05. Statistical analysis was carried using standard formulae. Microsoft Excel 2007 and SPSS (Statistical Package for Social Sciences) Version 17.0 software were used for data entry and analysis. CONCLUSIONS: Carotid stenosis was one of the common causes of ischaemic stroke. There was a statistically significant correlation between increasing age, male gender, smoking, diabetes mellitus, hypertension and hyperlipidemia and the prevalence of carotid stenosis. KEYWORDS: Carotid artery stenosis, Stroke, Ultrasonography. INTRODUCTION:Stroke remains the second leading cause of death worldWide 1 , after ischaemic heart disease. 85% of stroke cases are due to infarction and 15% are due to haemorrhagic. Patients with carotid artery stenosis are at higher risk of development of stroke and recurrence of stroke after a stroke/TIA. 2 Carotid atherosclerosis occurs in patients with atherosclerotic risk factors like diabetes mellitus (DM), hypertension (HTN), smoking and hyperlipidemia.Carotid atherosclerosis leads to plaque formation and these plaques gradually increase in size and cause stenosis. Atherosclerotic plaques interrupt the endothelium and then ulcerate. As the endothelium is breached, platelets adhere to the wall and a hemostatic plug is formed. This platelet nidus initiates coagulation cascade and an occlusive thrombus is formed. 2 Thrombus formation on an atherosclerotic plaque leads to distal embolisation and causes occlusion of blood vessels (Or) a severe stenosis may cau...

show abstract

“…In most of these studies, carotid artery disease was found to be significantly less frequent in patients with lacunar strokes compared with nonlacunar strokes. [31][32][33][34][35][36] The frequency of carotid disease in lacunar strokes has been considerably variable in different studies, ranging from 3% to 39%, [31][32][33][34][35][36][37][38][39][40][41] although it must be noted that the methodology used to both classify lacunar infarcts as well as to detect carotid disease also varied widely. A study of 726 patients with anterior circulation transient ischemic events or infarcts, excluding total anterior circulation infarcts, revealed a negative association of severe carotid stenosis with lacunar events.…”

Section: Carotid Artery Disease and Lacunar Infarctsmentioning

confidence: 99%

Is Investigating for Carotid Artery Disease Warranted in Non-Cortical Lacunar Infarction?

Rajapakse

Rajapakse²,

Sharma³

2011

Stroke

View full text Add to dashboard Cite

Abstract-Carotid intervention in severe carotid stenosis after an anterior circulation ischemic event reduces the risk of further infarcts if the surgery is performed soon after the incident event. At present, there is no recommendation to differentiate among subtypes of anterior circulation infarcts or transient ischemic events. However, evidence is mounting that demonstrates a difference in pathophysiology of lacunar and nonlacunar (large artery) infarcts. The natural history of lacunar strokes is different from large artery infarcts for recurrence and mortality. Stroke is a heterogenous disease and consideration needs to be directed to manage different stroke subtypes differently. Lacunar infarcts mostly do not arise from large artery atheromatous disease or by cardioembolic phenomena, and there is a negative predictive value for severe carotid stenosis in lacunar strokes. Thus, current evidence suggests that lacunar strokes may not warrant investigation for carotid stenosis. (Stroke. 2011;42:217-220.)

show abstract

Carotid disease in acute stroke

Cited by 41 publications

References 19 publications

Relationship Between Pattern of Intracranial Artery Abnormalities on Transcranial Doppler and Oxfordshire Community Stroke Project Clinical Classification of Ischemic Stroke

Relationship Between Pattern of Intracranial Artery Abnormalities on Transcranial Doppler and Oxfordshire Community Stroke Project Clinical Classification of Ischemic Stroke

Evaluation of Carotid Artery Stenosis in Stroke/Transient Ischaemic Attack

Is Investigating for Carotid Artery Disease Warranted in Non-Cortical Lacunar Infarction?

Contact Info

Product

Resources

About