Diagnosis and Prevention of Atherosclerotic Cerebral Infarction

AbstractAtherosclerotic disease accounts for ~25% of ischemic strokes. Atherosclerotic stroke is caused mainly by embolic events from the carotid artery bifurcation or the aortic arch, although intracranial thrombosis can occur, more often in African Americans, Asians, and diabetes patients. Primary prevention of stroke is critical for patients with risk factors for atherosclerosis, including hypertension, diabetes, smoking and hypercholesterolemia. Stroke can be prevented in patients with established atherosclerotic disease by identification and management of patients with carotid artery stenosis by non-invasive testing. Particular attention must be paid to patients with transient symptoms of brain ischemia.

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Clinical risk factors predictive of thrombotic stroke with large cerebral infarction

Neurology International ◽

10.4081/ni.2019.7941 ◽

2019 ◽

Vol 11 (2) ◽

Cited By ~ 1

Author(s):

Worapot Rojsanga ◽

Kittisak Sawanyawisuth ◽

Verajit Chotmongkol ◽

Somsak Tiamkao ◽

Kannikar Kongbonkiat ◽

...

Keyword(s):

Risk Factors ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Cerebral Infarction ◽

Carotid Artery Stenosis ◽

Stroke Risk ◽

Internal Carotid ◽

Internal Carotid Artery Stenosis ◽

Artery Stenosis ◽

Stroke Risk Factors

Large cerebral infarctions have high morbidity and mortality. Patients with large cerebral infarctions may have recurrent ischemia as high as 8.1% within 7 days; highest among other types of strokes. Data regarding risk factors for large cerebral infarction in Asian populations are still scant. All adult (age ≥15 years old) patients with the diagnosis of thrombotic ischemic stroke who were treated at Srinagarind Hospital, Khon Kaen University, Thailand from January 2012 to December 2013 were studied. Large cerebral infarctions are defined by clinical criteria of having cerebral cortical impairment, brain stem or cerebellar dysfunction with infarction sizes of more than 1.5 cm. The association of various stroke risk factors and large infarction strokes were calculated using multiple logistic regression analysis. There were 276 thrombotic stroke patients who met the study criteria; classified as large cerebral infarctions in 59 patients (21.38%) and small cerebral infarctions in 217 patients (78.62%). Baseline characteristics and risk factors for stroke were comparable between both groups. The large cerebral infarction group had a significantly larger proportions of right internal carotid artery stenosis, plaques on the left side, left internal carotid artery stenosis, and internal carotid artery stenosis at any side than the small cerebral infarction group. Among various stroke risk factors, only internal carotid artery stenosis at any side was the only significant factor associated with large cerebral infarction with an adjusted odds ratio of 11.14 (95% CI: 3.46, 35.82). In conclusion, significant internal carotid artery stenosis is associated with large cerebral infarction.

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Prevalence and risk factors for cerebral infarction and carotid artery stenosis in peripheral arterial disease

Atherosclerosis ◽

10.1016/j.atherosclerosis.2012.05.019 ◽

2012 ◽

Vol 223 (2) ◽

pp. 473-477 ◽

Cited By ~ 20

Author(s):

Yoshihiro Araki ◽

Hisao Kumakura ◽

Hiroyoshi Kanai ◽

Shu Kasama ◽

Hiroyuki Sumino ◽

...

Keyword(s):

Risk Factors ◽

Carotid Artery ◽

Peripheral Arterial Disease ◽

Cerebral Infarction ◽

Carotid Artery Stenosis ◽

Arterial Disease ◽

Artery Stenosis ◽

Peripheral Arterial

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PC054. Association Between Carotid Artery Stenosis and Atherosclerotic Disease Risk Score in a Screening Ultrasound Population

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.04.320 ◽

2019 ◽

Vol 69 (6) ◽

pp. e219

Author(s):

Mark D. Balceniuk ◽

Peng Zhao ◽

Brian C. Ayers ◽

Roan J. Glocker ◽

Michael C. Stoner

Keyword(s):

Carotid Artery ◽

Risk Score ◽

Carotid Artery Stenosis ◽

Disease Risk ◽

Artery Stenosis ◽

Atherosclerotic Disease ◽

Disease Risk Score ◽

Screening Ultrasound

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Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study

Bioscience Reports ◽

10.1042/bsr20190719 ◽

2021 ◽

Vol 41 (2) ◽

Author(s):

Yongtao Sun ◽

Hai Feng ◽

Ting Zou ◽

Ming Hou ◽

Yanwu Jin ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Carotid Artery ◽

Coronary Artery Bypass ◽

Cognitive Dysfunction ◽

Carotid Artery Stenosis ◽

Artery Bypass ◽

Postoperative Cognitive Dysfunction ◽

Aortic Plaque ◽

Anesthesia Time

Abstract Aim: To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinical prevention of POCD. A total of 88 patients who underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180 days post-surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which included Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ2 or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative day 2 had statistically significant (P<0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (odds ratio (OR) value > 1, P<0.05) are the risk factors for POCD. The incidence of day-21 and -180 POCD was approximately 26.1 and 22.7%, respectively.

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