Intracranial carotid artery calcification on head CT and its association with ischemic changes on brain MRI in patients presenting with stroke-like symptoms: retrospective analysis

Erbay, Sami H.; Han, Renfang; Baccei, Steven J.; Krakov, W.; Zou, Kelly H.; Bhadelia, Rafeeque A.; Polak, Joseph F.

doi:10.1007/s00234-006-0159-z

Cited by 55 publications

(51 citation statements)

References 30 publications

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“…This is in line with a study in stroke patients that showed an association between carotid calcification and acute lacunar infarcts on diffusion imaging, 28 but not with 2 others who found no association. 14,29 The small number of cortical infarcts did not allow us to analyze infarcts divided into cortical and lacunar infarcts per quartile of CT calcification.…”

Section: Discussionsupporting

confidence: 89%

Calcification in Major Vessel Beds Relates to Vascular Brain Disease

Bos

Ikram

Elias‐Smale

et al. 2011

ATVB

135

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Objective-Calcification in atherosclerotic plaques is a novel marker of atherosclerosis and is related to cardiovascular disease. However, its relationship with cerebrovascular disease has not been investigated extensively. We investigated the relationship between calcification in various vessel beds outside the brain and imaging markers of vascular brain disease. Methods and Results-A total of 885 community-dwelling people (mean age, 66.7 years) underwent computed tomography of the coronary arteries, aortic arch, and extracranial and intracranial carotid arteries to assess arterial calcification. Brain magnetic resonance imaging scans were performed to assess cerebral infarcts, microbleeds, and white matter lesions (WMLs

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Section: Discussionsupporting

confidence: 89%

Calcification in Major Vessel Beds Relates to Vascular Brain Disease

Bos

Ikram

Elias‐Smale

et al. 2011

ATVB

135

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“…In contrast, other studies report that IAC does not seem to play a major role in cerebral infarcts (31,32). Only Erbay et al reported a partial association between acute small vessel cerebral infarcts and high-grade internal carotid calcification (22). The latter authors suggested that IAC may be a marker for intracranial artery stenosis, an uncommon cause of ischemic stroke.…”

Section: Discussionmentioning

confidence: 93%

“…Calcification foci were defined as hyperdense foci with a median density greater than 130 Hounsfield units (21). The scoring system was based on a modification of the method originally described by Woodcock for calcification noted in carotid angiography and then adapted by Erbay for grading intracranial carotid artery calcification on CT scans (22,23). According to our modification, grade 0 corresponds to the absence of calcifications or tiny scattered calcification foci seen on only one slice, and grade 1 corresponds to thick contiguous calcification; thick interrupted calcification; thin confluent calcification; or tiny, scattered calcification foci seen on at least two adjacent slices (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

High Prevalence of Intracranial Artery Calcification in Stroke Patients with CKD

Bugnicourt¹,

Chillon²,

Massy³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Intracranial artery calcification (IAC) is frequently observed on brain computed tomography (CT) scans in stroke patients. This retrospective study was designed to determine the prevalence, risk factors, and clinical relevance of IAC in a cohort of patients with ischemic stroke.Design, setting, participants, & measurements: We included all eligible patients admitted to Amiens University Hospital for acute ischemic stroke between January and December 2006 and assessed using 64-slice multidetector-row CT (n ‫؍‬ 340). Patients were classified according to the presence or absence of IAC in the internal carotid arteries, middle cerebral arteries, vertebral arteries, and basilar artery. GFR was estimated using the MDRD equation. Chronic kidney disease (CKD) was defined as a GFR < 60 ml/min/1.73 m 2 . We also studied a control group of patients admitted for neurologic diseases other than stroke.Results: Two hundred fifty-nine stroke patients (76.2%) displayed IAC, which was independently associated with carotid atherosclerosis > 50%, age, and GFR. One hundred three nonstroke patients (60.2%) had IAC, with age, arterial hypertension, and GFR as independently associated factors. For all patients taken together, age, arterial hypertension, stroke, and GFR were independently associated with IAC.Conclusion: These results confirm the high prevalence of IAC in patients with and without ischemic stroke and show for the first time that IAC is associated with the presence of CKD in these patients. The frequency of IAC was significantly higher in stroke patients than in nonstroke patients. The association between IAC and stroke outcome requires further investigation.

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“…18,19 Only Erbay et al showed a relationship between small deep cerebral infarcts and severe IAC located in carotid arteries. 20 More recently, in a study based on a small sample size, no significant difference was demonstrated between severity of carotid atherosclerotic calcification and stroke incidence in a 3-year clinical follow-up. 21 It has been suggested for a long time that intracranial atherosclerosis may be a potential marker of extensive systemic atherosclerotic disease.…”

Section: Discussionmentioning

confidence: 94%

Presence of Intracranial Artery Calcification Is Associated With Mortality and Vascular Events in Patients With Ischemic Stroke After Hospital Discharge

Bugnicourt

Leclercq

Chillon

et al. 2011

Stroke

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Background and Purpose-Although intracranial artery calcification (IAC) has been reported to be a risk factor for ischemic stroke, the prognostic implications of IAC in stroke outcome are unknown. The purpose of this study was to determine the association between IAC and risk of vascular events and death in patients with stroke after hospital discharge. Methods-All patients with ischemic stroke over a 1-year period were included (nϭ302). IAC, assessed by multidetector CT, was defined as hyperdense foci (peak density Ͼ130 Hounsfield units) and assessed in the 7 major cerebral arteries. The IAC scores ranged from 0 (no calcification) to 7. Follow-up information on major clinical events (including fatal or nonfatal ischemic stroke, cardiac and peripheral artery events, and all-cause death) was obtained by means of a structured phone interview. Results-IAC was present in 260 patients (83%). With a mean follow-up of 773Ϯ223 days

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Intracranial carotid artery calcification on head CT and its association with ischemic changes on brain MRI in patients presenting with stroke-like symptoms: retrospective analysis

Cited by 55 publications

References 30 publications

Calcification in Major Vessel Beds Relates to Vascular Brain Disease

Calcification in Major Vessel Beds Relates to Vascular Brain Disease

High Prevalence of Intracranial Artery Calcification in Stroke Patients with CKD

Presence of Intracranial Artery Calcification Is Associated With Mortality and Vascular Events in Patients With Ischemic Stroke After Hospital Discharge

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