Neurology (Stroke)

Background: Cerebral artery stenosis is an important risk factor for ischemic strokes. This study aims to explore intracranial and extracranial artery stenosis in a large northeast Chinese cohort. Methods: We recruited 14793 outpatients and hospitalized patients to identify cerebral artery stenosis. Artery stenosis screening was done with transcranial Doppler (TCD) for intracranial arteries and carotid duplex sonography for extracranial arteries. Results: More intracranial than extracranial artery stenoses were identified (4255 versus 2809, i.e. 28.8% versus 19.0%, P<0.05). Similarly, mere intracranial stenosis was significantly more common than extracranial artery stenosis in this population (2632 versus 1186, i.e. 17.8% versus 8%, P<0.05). Among all identified intracranial arteries stenoses, the proportion of middle cerebral artery (MCA) stenosis was the highest. More intracranial than extracranial artery stenoses was seen within each age group, and rates of both increased with age. Intracranial and extracranial artery stenosis was more frequently identified in males than females. Conclusions: Incidence of cerebral artery stenosis in the population increases with age. Intracranial artery stenosis is more common than extracranial artery stenosis and the MCA stenosis accounted for the highest proportion, within each age group. More males suffer from intracranial or extracranial artery stenosis than females.

Download Full-text

Bypass Surgery for Ischemic Stroke Caused by Intracranial Artery Stenosis or Occlusion

Brain Science Advances ◽

10.26599/bsa.2018.9050003 ◽

2018 ◽

Vol 4 (1) ◽

pp. 49-60 ◽

Cited By ~ 1

Author(s):

Ismatullah Soufiany ◽

Khalil Ahmad Hijrat ◽

Spina Soufiany ◽

Lukui Chen

Keyword(s):

Ischemic Stroke ◽

Cerebral Artery ◽

Vegetative State ◽

Superficial Temporal Artery ◽

Case Series ◽

Temporal Artery ◽

Artery Stenosis ◽

Intracranial Stenosis ◽

Intracranial Artery ◽

Intracranial Artery Stenosis

Surgical revascularization may be beneficial in patients with ischemic stroke caused by intracranial stenosis or occlusion who are ineligible for thrombolysis. Objective To evaluate the outcome of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in ischemic stroke caused by intracranial artery stenosis or occlusion. Methods We retrospectively studied successive case series of 19 patients who underwent surgical treatment between 2013–2017 of STA-MCA bypass. Surgical procedure was performed for the patients with acute ischemic stroke who were ineligible for thrombolysis. Results Of the 19 patients enrolled, symptom aggravation occurred during medical treatment, the patients were ineligible for thrombolysis despite being within 8 hours of symptom onset. Bypass significantly improved National Institutes of Health Stroke Scale scores, mean patient age was 78.05 years (range, 39–78 y). However, male 11 (57.95%) out of nineteen patients were presented with left-sided-lesions while female 8 (42%) had right-sided lesions with significant infarction growth by diffusion weighted imaging achieved, after surgical maneuver. No major complications occurred intraoperatively, in contrast to 2 (10.5%) minor manifestation were suffering minor complications probably they included the remote infarction (posterior cerebral artery territory). Pooled analysis with our patients showed a significant neurological improvement and a good outcome in 13 (68.4%) patients without hemorrhage or any other complication, 6 (31.6%) patients with unfavorable outcome (severe disability 2; vegetative state 4, non of them are died 0;). Conclusion STA-MCA bypass may be beneficial to patients with acute stroke or stenosis in progress who are ineligible for medical therapy. Furthermore, it appears safe when the infarction is small. These findings indicate that STA-MCA bypass could be considered as a treatment option in selected patients with ischemic stroke caused by intracranial stenosis or occlusion.

Download Full-text

Association of Carotid and Intracranial Stenosis with Alzheimer’s Disease Biomarkers

10.21203/rs.3.rs-19023/v1 ◽

2020 ◽

Author(s):

Koung Mi Kang ◽

Min Soo Byun ◽

Jun Ho Lee ◽

Dahyun Yi ◽

Hye Jeong Choi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Hippocampal Volume ◽

Artery Stenosis ◽

Intracranial Artery ◽

Positron Emission ◽

Intracranial Artery Stenosis ◽

Intracranial Arteries ◽

Demographic Covariates

Abstract Background To clarify whether atherosclerosis of the carotid and intracranial arteries is related to Alzheimer’s disease (AD) pathology in vivo, we investigated the associations of carotid and intracranial artery stenosis with cerebral beta-amyloid (Aβ) deposition and neurodegeneration in middle- and old-aged individuals. Given the differential progression of Aβ deposition and neurodegeneration across clinical stages of AD, we focused separately on cognitively normal (CN) and cognitively impaired (CI) groups.Methods A total of 281 CN and 199 CI (mild cognitive impairment and AD dementia) subjects underwent comprehensive clinical assessment, [11C] Pittsburgh Compound B positron emission tomography, and magnetic resonance (MR) imaging including MR angiography. We evaluated extracranial carotid and intracranial arteries for the overall presence, severity (i.e. number and degree of narrowing) and location of stenosis.Results We found no associations between carotid and intracranial artery stenosis and cerebral Aβ burden in either CN or CI group. In terms of AD-related neurodegeneration, exploratory univariate analyses showed associations between the presence and severity of stenosis and neurodegeneration biomarkers of AD (i.e. reduced hippocampal volume [HV] and cortical thickness in the AD-signature regions) in both CN and CI groups. In confirmatory multivariate analyses controlling for demographic covariates and diagnosis, the association between number of stenotic intracranial arteries ≥ 2 and reduced HV in the CI group remained significant.Conclusions Neither carotid nor intracranial artery stenosis appears to be associated with brain Aβ burden, while intracranial artery stenosis is related to amyloid-independent neurodegeneration, particularly hippocampal atrophy. These observations support the importance of proper management of intracranial artery stenosis for delaying the progression of AD neurodegeneration and related cognitive decline.

Download Full-text

1165 Is hemorrhagic stroke the major clinical manifestation in adult moyamoya disease? A retrospective study since transcranial Doppler (TCD) was available to be a screen method for diagnosing the intracranial artery stenosis in Chinese

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(05)81529-1 ◽

2005 ◽

Vol 238 ◽

pp. S397

Keyword(s):

Retrospective Study ◽

Clinical Manifestation ◽

Moyamoya Disease ◽

Transcranial Doppler ◽

Hemorrhagic Stroke ◽

Artery Stenosis ◽

Intracranial Artery ◽

Screen Method ◽

Intracranial Artery Stenosis ◽

Adult Moyamoya Disease

Download Full-text

Prevalence of middle cerebral artery stenosis in asymptomatic subjects of more than 40 years age group: A transcranial Doppler study

Neurology India ◽

10.4103/0028-3886.144443 ◽

2014 ◽

Vol 62 (5) ◽

pp. 510 ◽

Cited By ~ 2

Author(s):

Subash Kaul ◽

Sujay Sada ◽

Yugandhar Reddy ◽

Sampath Rao ◽

Suvarna Alladi

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Transcranial Doppler ◽

Artery Stenosis ◽

Age Group ◽

Doppler Study ◽

Group A ◽

Asymptomatic Subjects ◽

Middle Cerebral Artery Stenosis

Download Full-text

Accuracy of Transcranial Doppler Ultrasound Compared with Magnetic Resonance Angiography in the Diagnosis of Intracranial Artery Stenosis

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-1696586 ◽

2019 ◽

Vol 10 (03) ◽

pp. 400-404

Author(s):

Sandip Kumar Jaiswal ◽

Yan Fu-ling ◽

Lihua Gu ◽

Renardo Lico ◽

Fu Changyong ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Cerebral Artery ◽

Transcranial Doppler ◽

Posterior Circulation ◽

Intracranial Artery ◽

Anterior Circulation ◽

Predictive Values ◽

Intracranial Artery Stenosis ◽

Sensitivity Specificity

Abstract Background One of the most common causes of acute cerebral infarction (ACI) is intracranial artery stenosis (ICAS). The goal of our study was to evaluate the accuracy of transcranial Doppler (TCD) compared with magnetic resonance angiography (MRA) for diagnosing ICAS in patients with ACI. Materials and Methods Consecutive patients presenting with ACI to the neurology department underwent both MRA and TCD examination within 6 hours of difference. To calculate the agreement between the results of MRA and TCD, kappa coefficient test was used. Sensitivity, specificity, and positive and negative TCD predictive values have been calculated in comparison with MRA. Results A total of 115 patients was included. There were 77 males (66.95%) and 38 females (33.04%). The mean age of patients was 68.32 ± 10.66 years (range 29–80). The agreement between TCD and MRA in detecting stenosis was 0.56 for anterior circulation artery (ACA), and 0.40 for posterior circulation artery. For the detection of ICAS, sensitivity, specificity, positive predictive value, and negative predictive values were 85.9, 90.0, 98.2, and 50.0% for anterior cerebral artery and 73.5, 86.7, 96.2, and 40.0% for posterior cerebral artery, respectively. Conclusions Moderate agreement of anterior circulation stenosis and fair agreement for posterior circulation stenosis was found between TCD and MRA in the evaluation of ICAS. In anterior circulation, the diagnostic accuracy of TCD is higher compared with the posterior circulation.

Download Full-text

Association of carotid and intracranial stenosis with Alzheimer’s disease biomarkers

Alzheimer s Research & Therapy ◽

10.1186/s13195-020-00675-6 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Koung Mi Kang ◽

◽

Min Soo Byun ◽

Jun Ho Lee ◽

Dahyun Yi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Hippocampal Volume ◽

Artery Stenosis ◽

Intracranial Artery ◽

Positron Emission ◽

Intracranial Artery Stenosis ◽

Intracranial Arteries ◽

Demographic Covariates

Abstract Background To clarify whether atherosclerosis of the carotid and intracranial arteries is related to Alzheimer’s disease (AD) pathology in vivo, we investigated the associations of carotid and intracranial artery stenosis with cerebral beta-amyloid (Aβ) deposition and neurodegeneration in middle- and old-aged individuals. Given different variations of the pathologies between cognitive groups, we focused separately on cognitively normal (CN) and cognitively impaired (CI) groups. Methods A total of 281 CN and 199 CI (mild cognitive impairment and AD dementia) subjects underwent comprehensive clinical assessment, [11C] Pittsburgh compound B-positron emission tomography, and magnetic resonance (MR) imaging including MR angiography. We evaluated extracranial carotid and intracranial arteries for the overall presence, severity (i.e., number and degree of narrowing), and location of stenosis. Results We found no associations between carotid and intracranial artery stenosis and cerebral Aβ burden in either the CN or the CI group. In terms of neurodegeneration, exploratory univariable analyses showed associations between the presence and severity of stenosis and regional neurodegeneration biomarkers (i.e., reduced hippocampal volume [HV] and cortical thickness in the AD-signature regions) in both the CN and CI groups. In confirmatory multivariable analyses controlling for demographic covariates and diagnosis, the association between number of stenotic intracranial arteries ≥ 2 and reduced HV in the CI group remained significant. Conclusions Neither carotid nor intracranial artery stenosis appears to be associated with brain Aβ burden, while intracranial artery stenosis is related to amyloid-independent neurodegeneration, particularly hippocampal atrophy.

Download Full-text

Faculty Opinions recommendation of Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718157964.793490635 ◽

2014 ◽

Author(s):

Ming Liu ◽

Bo Wu

Keyword(s):

High Risk ◽

Medical Treatment ◽

Randomised Trial ◽

Artery Stenosis ◽

Intracranial Artery ◽

High Risk Patients ◽

Intracranial Artery Stenosis ◽

Risk Patients

Download Full-text

Rare RNF213 variants and the risk of intracranial artery stenosis/occlusion disease in Chinese population: a case-control study

BMC Medical Genetics ◽

10.1186/s12881-019-0788-9 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 6

Author(s):

Xin Liao ◽

Tong Zhang ◽

Bingyang Li ◽

Shimin Hu ◽

Junyu Liu ◽

...

Keyword(s):

Chinese Population ◽

Case Control Study ◽

Case Control ◽

Artery Stenosis ◽

Intracranial Artery ◽

Intracranial Artery Stenosis ◽

Control Study

Download Full-text

Abstract T P101: Low Serum Eicosapentaenoic Acid- Arachidonic Acid Ratio is Associated With Intracranial Stenosis in Patients With Acute Ischemic Stroke

Stroke ◽

10.1161/str.45.suppl_1.tp101 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Yuko Abe ◽

Ryoichi Otsubo ◽

Sho Murase ◽

Kenichiro Nakazawa ◽

Kazuo Kitagawa

Keyword(s):

Risk Factors ◽

Arachidonic Acid ◽

Ischemic Stroke ◽

Eicosapentaenoic Acid ◽

Acute Ischemic Stroke ◽

Artery Stenosis ◽

Intracranial Artery ◽

Stroke Subtype ◽

Fa Composition ◽

Intracranial Artery Stenosis

Purpose: A low ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) has been associated with atherosclerotic disease. Few studies investigate the association of serum fatty acid (FA) composition with the acute ischemic stroke so far. Our aim of this study is to evaluate the relationships between FA composition and stroke subtypes, extra-/intracranial atherosclerotic stenoses, and other cerebrovascular indicators Methods: This study included 154 consecutive patients who were admitted to our hospital because of acute ischemic stroke between April 2011 and March 2012. We examined the FA composition and classical vascular risk factors. We conducted brain MRI/MRA, carotid ultrasonogram, transthoracic echocardiogram, 24hr Holter electrocardiogram, ankle brachial index (ABI) and pulse wave velocity (PWV) in order to evaluate the severity of atherosclerotic change, stroke subtype, and cardiovascular status. Results: The mean value of EPA/AA was 0.33±0.22 in all patients with acute cerebral infarction. The 154 patients in this study (mean age 71 years) were categorized as follows; large artery atherosclerosis (LA; n=57), small artery occlusion (SA; n=48), cardiogenic embolism (CE; n=18), and others (n=31). We found intracranial artery stenosis greater than 50% in 70 patients (45%). The intracranial artery stenosis was associated with low EPA/AA ratio (P=0.013) and low EPA concentration (P=0.013). This association remained significant (P<0.05) after controlling for classical atherosclerotic risk factors. We could not find a significant correlation between FA composition and stroke subtype. However, there was a tendency for the EPA/AA ratio of LA patients to be the lowest among all subtype groups. The EPA/AA ratio was not associated with ABI, PWV, prevalence of arrhythmia, or cardiac function. Conclusions: A low EPA/AA ratio was significantly associated with intracranial stenosis in patients with acute ischemic stroke. This study shows the EPA/AA ratio might be an important marker to reflect the cerebral artery stenosis.

Download Full-text