scholarly journals Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Olli Patrakka ◽  
Helena Mehtonen ◽  
Sari Tuomisto ◽  
Juha-Pekka Pienimäki ◽  
Jyrki Ollikainen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Oral Health ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Oral Pathology ◽  
Artery Stenosis ◽  
Bacterial Dna ◽  
Carotid Artery Atherosclerosis

Background and purpose. Risk of acute ischemic stroke has been associated with carotid artery atherosclerosis as well as with periodontal disease. We studied whether oral pathology or carotid atherosclerosis was associated with the presence and quantity of bacterial DNA in their aspirated thrombi. Methods. Thrombus aspirates and control arterial blood were taken from 71 patients (70.4% male; mean age, 67.4 years) with acute ischemic stroke. Tooth pathology was registered using CT scans. Carotid stenosis was estimated with CTA and ultrasonography. The presence of bacterial DNA from aspirated thrombi was determined using quantitative PCR. We also analyzed the presence of these bacterial DNAs in carotid endarterectomies from patients with peripheral arterial disease. Results. Bacterial DNA was found in 59 (83.1%) of the thrombus aspirates (median, 8.6-fold). Oral streptococcal DNA was found in 56 (78.9%) of the thrombus aspirates (median, 5.1-fold). DNA from A. actinomycetemcomitans and P. gingivalis was not found. Most patients suffered from poor oral health and had in median 19.0 teeth left. Paradoxically, patients with better oral health had more oral streptococcal DNA in their thrombus than the group with the worst pathology ( p = 0.028 ). There was a trend (OR 7.122; p = 0.083 ) in the association of ≥50% carotid artery stenosis with more severe dental pathology. Oral streptococcal DNA was detected in 2/6 of carotid endarterectomies. Conclusions. Stroke patients had poor oral health which tended to associate with their carotid artery stenosis. Although oral streptococcal DNA was found in thrombus aspirates and carotid endarterectomy samples, the amount of oral streptococcal DNA in thrombus aspirates was the lowest among those with the most severe oral pathology. These results suggest that the association between poor oral health and acute ischemic stroke is linked to carotid artery atherosclerosis.

scholarly journals Duplex Study of Carotid Artery in Patients with Ischemic Stroke

2013 ◽  
Vol 28 (2) ◽  
pp. 67-73
Author(s):  
Nasreen Sultana ◽  
AKM Faslul Bari ◽  
Touhidul Karim Majumder ◽  
Md Rafiqul Islam ◽  
Ferdous Ara Hossain
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Total Occlusion ◽  
Ischemic Lesion ◽  
Significant Stenosis

Objective: To determine the frequency and characteristics of carotid artery stenosis in acute ischemic stroke patients and to assess the significance of common risk factors for carotid stenosis in these patients. Method: It was cross-sectional observational study which was carried out in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of January 2010 to December 2011 and one hundred patients admitted with acute ischemic stroke were included in the study. Doppler ultrasound was performed during hospitalization to find out carotid artery stenosis. Statistics analysis was done with SPSS - 14. Results: Out of one hundred (100) patients, eighty (80%) were males and twenty were (20%) were females. The patients were dividing into two groups with and without carotid stenosis. Less than 50% carotid artery stenosis (insignificant stenosis) was seen in 40% ( n=40) cases and significant stenosis was seen in 60% (n=60) patients. Overall 86% (n= 46) out of 60 patients were found to have carotid artery stenosis on the ipsilateral side corresponding to the ischemic lesion and 19% (n=11) had stenosis on the contralateral side. Out of significant stenosis ,mild (50% stenosis) in 12% (n=7) patients, moderate ( 51-69% ) stenosis in 50%( n= 30 ) patients and severe (>70%) stenosis in twenty (n=33%) patients . Near total occlusion was seen in three (5%) patients. The presence of stenosis was significantly correlated with older age and the presence of multiple risk factors. Conclusion: Carotid artery stenosis is strongly associated with ischemic stroke. Doppler studies are recommended for the high risk patients for the primary as well as secondary prevention of ischemic stroke.DOI: http://dx.doi.org/10.3329/bjn.v28i2.17172 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 67-73

Carotid Artery Stenosis Is Associated with Better Intracranial Collateral Circulation in Stroke Patients

2020 ◽  
Vol 49 (2) ◽  
pp. 200-205
Author(s):  
Juha-Pekka Pienimäki ◽  
Niko Sillanpää ◽  
Pasi Jolma ◽  
Sara Protto
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Clinical Outcome ◽  
Acute Stroke ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Collateral Circulation ◽  
Artery Stenosis ◽  
Stroke Patients ◽  
Significant Difference

Background: Adequate collateral circulation improves the clinical outcome of ischemic stroke patients. We evaluated the influence of ipsilateral carotid stenosis on intracranial collateral circulation in acute stroke patients. Methods: We collected the data of 385 consecutive acute stroke patients who underwent mechanical thrombectomy after multimodal computed tomography (CT) imaging in a single high-volume stroke center. Patients with occlusion of the first segment (M1) segment of the middle cerebral artery were included. We recorded baseline clinical, laboratory, procedural, and imaging variables and technical, imaging, and clinical outcomes. The effect of carotid stenosis on intracranial collateral circulation was studied with appropriate statistical tests and ordinal regression analysis. Results: Fifty out of the 247 patients eligible for analysis had severe ipsilateral carotid stenosis (≥75%). These patients were 4-times more likely to have very good intracranial collaterals (Collateral Score 3–4, p = 0.001) than the nonstenotic and slightly stenotic (<75%) patients. The severely stenotic patients had a longer mean operation time (41 vs. 29 min to reperfusion, respectively, p = 0.001). Nevertheless, 54% of severely stenotic patients had good 3-month clinical outcome (modified Rankin Scale ≤2) with no significant difference between the 2 groups. Conclusions: Carotid artery stenosis of over 75% of vessel diameter was associated with better intracranial collateral circulation of patients with acute ischemic stroke. This did not significantly change the 3-month clinical outcome.

Effects of Blood Pressure Lowering in Patients with Acute Ischemic Stroke and Carotid Artery Stenosis

2014 ◽  
Vol 10 (3) ◽  
pp. 354-359 ◽  
Author(s):  
Mirza Jusufovic ◽  
Else Charlotte Sandset ◽  
Philip M. W. Bath ◽  
Björn W. Karlson ◽  
Eivind Berge
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Blood Pressure Lowering ◽  
Pressure Lowering

scholarly journals Ischemic stroke secondary to self-inflicted carotid sinus massage: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Edgar R. Lopez-Navarro ◽  
Götz Greif ◽  
Carl-Albrecht Haensch ◽  
Adrian Ringelstein ◽  
Robert Larbig
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Stroke Unit ◽  
Carotid Sinus ◽  
White Male ◽  
Magnetic Resonance Images ◽  
Artery Stenosis ◽  
Carotid Sinus Massage

Abstract Background The risk of stroke after carotid sinus massage is greater if there is preexisting carotid stenosis or carotid plaques. We present the case of a patient with underlying 40% carotid stenosis, who developed a watershed stroke after a self-neck massage in our stroke unit. We show a well-documented case with magnetic resonance images before and after the neck massage. We report a case of a watershed brain infarct after a self-massage of the carotid sinus, with preexisting carotid artery stenosis. Neck massage continues to be a significant cause of stroke and should therefore not be performed by patients. Clinicians must be aware of the implications of a carotid sinus massage in both the outpatient and inpatient settings. Case presentation We admitted a 58-year-old white male patient, with no relevant medical history, to our department with a brain stem infarct. During his stay at our stroke unit, the patient performed a self-neck massage with consecutive bradycardia and asystole, resulting in left-side hemiparesis. The underlying cause of the hemodynamic stroke is believed to be secondary to this intensive neck massage performed by the patient. The patient also suffered from unknown right internal carotid artery stenosis. Conclusion Clinicians and patients must be aware that neck massage can lead to ischemic stroke. We postulate that repetitive impaired cardiac output can lead to a hemodynamic (watershed-type) stroke.

Carotid Artery Stenosis in Diabetic Patients Presenting With Acute Ischemic Stroke

2020 ◽  
Author(s):  
Ahsan Ashfaq
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Artery Stenosis ◽  
Cross Sectional Study ◽  
Artery Stenosis ◽  
P Value ◽  
Diabetic Patients ◽  
Chi Square ◽  
Cross Sectional

Background: Stroke is the commonest life-threatening neurological disorder. The Abnormal narrowing or stenosis of the Carotid Artery is a major determinant of ischemic stroke in diabetic patients. The main objective of study was to estimate the frequency of carotid artery stenosis in diabetic patients presenting with acute ischemic stroke. Methods: This was a Cross-Sectional study conducted at Medicine wards Jinnah Post-Graduate Medical Centre, Karachi from 5th December 2014 to 5th June 2015. Total 101 patients were included. During the hospitalization, patients were subjected to carotid Doppler ultrasonography to assess carotid artery stenosis. Patients were provided routine medical care during the hospitalization. Data was analyzed using SPSS v23.0. Chi-Square was used to analyze the differences between the categories. The p-value of <0.05 was considered as significance. Results: Total 101 patients were included in the study. There were 71.8% males and 28.2% females. The mean age was 53.7±10.2 years. On analysis of risk factors, it was observed that 59% patients had hypertension, 34.2% patients were obese, 34.2% patients had dyslipidemia, 51.3% patients had history of smoking. On analysis of carotid artery stenosis among the diabetics, it was observed that 20.8% diabetics had carotid artery stenosis. Conclusion: Stenosis of Carotid artery was common in patients suffering from acute ischemic stroke and diabetes mellitus. Among modifiable risk factor in patients with stroke having carotid artery stenosis, Hypertension was most common whereas fasting blood sugar FBS level greater than 100 g/dl lead to increased chances of having carotid artery stenosis.

scholarly journals Early Carotid Endarterectomy for Critical Carotid Artery Stenosis After Thrombolysis Therapy in Acute Ischemic Stroke in the Middle Cerebral Artery

Stroke ◽  
2001 ◽  
Vol 32 (9) ◽  
pp. 2075-2080 ◽  
Author(s):  
Christopher M. McPherson ◽  
Daniel Woo ◽  
Paul L. Cohen ◽  
Arthur M. Pancioli ◽  
Brett M. Kissela ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Cerebral Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Thrombolysis Therapy

scholarly journals Cognitive Impairment: A Retrospective Study of Carotid Artery Stenosis

2019 ◽  
Vol 2 (1) ◽  
pp. 01-03
Author(s):  
M Gennaro
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Retrospective Study ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Artery Stenosis ◽  
Vascular Cognitive Impairment ◽  
Artery Stenosis ◽  
Stroke Patients

Acute ischemic stroke has been recognized as one key cause of vascular cognitive impairment (VCI). The purpose of this study was to evaluate the correlation between carotid artery stenosis and post VCI in acute ischemic stroke patients.

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