The relation between hyperhomocysteinemia and the intima-media complex thickness in common carotid artery, as risk factors for ischemic stroke

2018 ◽  
Vol 31 (06) ◽  
Author(s):  
Monika Chorazy ◽  
Dominika Jakubowicz-Lachowska ◽  
Michal Szczepanski ◽  
Katarzyna Krystyna Snarska ◽  
Agata Krajewska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Common Carotid Artery

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

scholarly journals Dilatation of common carotid artery is strongly associated with cerebral ischemic stroke with or without the presence of carotid atherosclerosis

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 365-365
Author(s):  
Jiunn-Rong Chen ◽  
Chyi-Huey Bai ◽  
Hou-Chang Chiu ◽  
Wen-Harn Pan
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Atherosclerosis ◽  
Previous History ◽  
External Carotid ◽  
Compensatory Mechanism ◽  
Plaque Score ◽  
Diabetes Status

P147 Background: Dilatation of common carotid artery (CCA) was related to age, sex, and body height in population studies. It was also considered a compensatory mechanism to carotid atherosclerotic stenosis. The present study examined the risk of CCA dilatation associated with ischemic stroke (IS) and its relations to carotid atherosclerosis, hypertension, hyperglycemia, fibrinogen, cholesterol, HDL-cholesterol (HDL-C), smoking, and alcohol consumption. Methods: A case-control study was carried on 251 first-ever IS patients (age≥40) excluding previous history of myocardial infarction and cancer and 242 non-stroke outpatients. Intraluminal diameter of middle portion of CCA, and plaque thickness in CCA, bulb, internal and external carotid arteries were measured. Information on hypertension and diabetes status and data of life-styles such as smoking and alcohol consumption were collected. Levels of fibrinogen, factor VIIIc, cholesterol, HDL-C and glucose were obtained. Results: CCA dilatation was a strong factor for IS (OR=4.13, P=0.0001). It was also associated with hypertension, hyperglycemia, smoking, alcohol consumption, low HDL-C, and high levels of fibrinogen, factor VIIIc, cholesterol, and plaque score. The association remained significant with or without each of the following conditions: hypertension (p=0.0001, p=0.0007), hyperglycemia (p=0.0446, p=0.0001), elevated fibrinogen (p=0.0104, p=0.0001) or factor VIIIc (p=0.2458, p=0.0001), hypercholesterolemia (p=0.0238, p=0.0001), decreased HDL-C (p=0.0012, p=0.0001) and presence of plaque score (p=0.0263, p=0.0003). Adjusting above risk factors, odds ratios of elevated diameter could associated with IS, before (OR=2.21, P=0.0066) and after (OR=6.63, p=0.0055) excluding subjects with plaque. Conclusion: Dilatation of CCA is a strong risk factor for IS. The fact the association remained significant without ultrasonic evidence of carotid plaque indicates that IS in Chinese involved a mechanism of active vasculopathy, not just a passive compensatory process to extracranial atherosclerosis.

scholarly journals Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

2021 ◽  
Vol 7 (9) ◽  
pp. 1534
Author(s):  
Birame Loum ◽  
Cheikh Ahmedou Lame ◽  
Cheikhna B. Ndiaye ◽  
Kamadore Toure ◽  
Mouhamadou Mansour Ndiaye
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Condition ◽  
Styloid Process ◽  
Neurological Impairment ◽  
Vascular Events ◽  
Eagle Syndrome

<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>

scholarly journals Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

2019 ◽  
Vol 8 (2) ◽  
pp. 66-71
Author(s):  
Dipesh Shakya ◽  
Rabindra Shrestha ◽  
Krishna Dhungana ◽  
Raisha Kafle ◽  
Sabnam Bhatta
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Public Awareness ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Carotid Artery Atherosclerosis ◽  
Common Risk Factors

Background: Stroke is a disabling condition that has physical and mental impact on a patient’s life. Stroke is an important morbidity for low and middle income countries like Nepal. Hypertension, diabetes, smoking, and dyslipidemia are common risk factors in this regard and are inadequately controlled; mainly because of poor public awareness, inadequate infrastructure, lack of service and qualified manpower.Objectives: This study aims to provide insight into the epidemiology and risk factors in ischemic stroke patients.Methodology: A descriptive cross sectional study was conducted in 92 ischemic stroke patients at a tertiary care hospital Kathmandu Medical College and Teaching Hospital (KMCTH), Sinamangal, Nepal from December 2017 to June 2018. Consecutive sampling technique was used and data was collected from ischemic stroke patients above 14 years of age who were admitted in the Department of Neurology. Information regarding pre-morbid and morbid conditions, imaging findings as well as results was obtained from biochemical analysis of blood after taking consent from the patient or patient’s relative. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis.Results: Their mean age was 63.25 years with standard deviation of 16.45. Dyslipidemia was the most commonly found risk factor which was present in 77.2% of the subjects, followed by smoking (59.8%), presence of carotid artery atherosclerosis (59.8%), hypertension (50%), atrial fibrillation (26.1%) and diabetes mellitus(15.2%). Smoking was significant in males and heart disease was mostly seen in females.Conclusion: Dyslipidemia and smoking were the most common risk factors followed by carotid artery atherosclerosis. Patients with hypertension and dyslipidemia had higher incidence of stroke in both young and elderly group.

High Spatial Inhomogeneity in the Intima-Media Thickness of the Common Carotid Artery is Associated with a Larger Degree of Stenosis in the Internal Carotid Artery: The PARISK Study

2016 ◽  
Vol 38 (05) ◽  
pp. 523-529 ◽  
Author(s):  
Jeire Steinbuch ◽  
Anouk van Dijk ◽  
Floris Schreuder ◽  
Martine Truijman ◽  
Alexandra de Rotte ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
Common Risk Factors ◽  
The Common ◽  
Ica Stenosis

Abstract Purpose Inhomogeneity of arterial wall thickness may be indicative of distal plaques. This study investigates the intra-subject association between relative spatial intima-media thickness (IMT) inhomogeneity of the common carotid artery (CCA) and the degree of stenosis of plaques in the internal carotid artery (ICA). Materials and Methods We included 240 patients with a recent ischemic stroke or transient ischemic attack and mild-to-moderate stenosis in the ipsilateral ICA. IMT inhomogeneity was extracted from B-mode ultrasound recordings. The degree of ICA stenosis was assessed on CT angiography according to the European Carotid Surgery Trial method. Patients were divided into groups with a low (≤ 2 %) and a high (> 2 %) IMT inhomogeneity scaled with respect to the local end-diastolic diameter. Results 182 patients had suitable CT and ultrasound measurements. Relative CCA-IMT inhomogeneity was similar for the symptomatic and asymptomatic side (difference: 0.02 %, p = 0.85). High relative IMT inhomogeneity was associated with a larger IMT (difference: 235 µm, p < 0.001) and larger degree of ICA stenosis (difference: 5 %, p = 0.023) which remained significant (p = 0.016) after adjustment for common risk factors. Conclusion Regardless of common risk factors, high relative CCA-IMT inhomogeneity is associated with a greater degree of ICA stenosis and is therefore indicative of atherosclerotic disease. The predictive value of CCA-IMT inhomogeneity for plaque progression and recurrence of cerebrovascular symptoms will be determined in the follow-up phase of PARISK.

Endovascular Treatment of Tandem Common Carotid Artery Origin and Distal Intracranial Occlusion in Acute Ischemic Stroke

2017 ◽  
Vol 97 ◽  
pp. 360-365 ◽  
Author(s):  
Gregory M. Weiner ◽  
Rafey Feroze ◽  
David M. Panczykowski ◽  
Amin Aghaebrahim ◽  
William Ares ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Common Carotid Artery

scholarly journals Remnant Cholesterol and Common Carotid Artery Intima-Media Thickness in Patients With Ischemic Stroke

2021 ◽  
Author(s):  
Sifan Qian ◽  
Shoujiang You ◽  
Yaming Sun ◽  
Qiuyi Wu ◽  
Xianhui Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Lipoprotein Cholesterol ◽  
Media Thickness ◽  
Cholesterol Levels ◽  
Remnant Cholesterol

Background: Remnant cholesterol makes great contribution to residual risk of cardiovascular disease, but population-based evidence on the relationship between remnant cholesterol and atherosclerosis is rare. Common carotid artery intima-media thickness (cIMT) is an imaging marker of subclinical atherosclerosis. We aimed to explore the association between remnant cholesterol levels and cIMT in patients with ischemic stroke. Methods: One thousand four hundred ninety-six ischemic stroke patients with baseline serum lipids and carotid artery imaging data were included in this analysis. Fasting remnant cholesterol was calculated as total cholesterol minus HDL (high-density lipoprotein) cholesterol minus LDL (low-density lipoprotein) cholesterol. Abnormal cIMT was defined as mean cIMT and maximum cIMT value ≥1 mm. Logistic regression and restricted cubic spline models were used to assess the relationships between remnant cholesterol levels and abnormal cIMT. Results: The multivariable-adjusted odds ratios (95% CIs) for the highest versus lowest quartile of remnant cholesterol were 2.06 (1.46–2.91) for abnormal mean cIMT and 1.70 (1.23–2.35) for abnormal maximum cIMT. There were linear associations between remnant cholesterol levels and both abnormal mean cIMT ( P for linearity, <0.001) and abnormal maximum cIMT ( P for linearity, 0.003). Moreover, the remnant cholesterol–cIMT association remained significant in the subsample of patients with optimal LDL cholesterol levels (n=179). Conclusions: Elevated fasting remnant cholesterol levels were positively associated with mean cIMT and maximum cIMT in patients with ischemic stroke, even in patients with optimal LDL cholesterol levels. Future prospective studies are needed to verify our findings and to assess the effect of remnant cholesterol–lowering interventions in patients with ischemic stroke.

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