scholarly journals Measurement of Cortical Atrophy and Its Correlation to Memory Impairment in Patients With Asymptomatic Carotid Artery Stenosis Based on VBM-DARTEL

2021 ◽  
Vol 13 ◽  
Author(s):  
Peijiong Wang ◽  
Husule Cai ◽  
Rutao Luo ◽  
Zihao Zhang ◽  
Dong Zhang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Memory Impairment ◽  
Memory Function ◽  
Underlying Mechanism ◽  
Artery Stenosis ◽  
Middle Frontal Gyrus ◽  
Cortical Atrophy ◽  
Anterior Circulation ◽  
Pars Opercularis

ObjectiveSevere carotid artery stenosis (CAS) can lead to atrophy of gray matter (GM) and memory impairment; however, the underlying mechanism is unknown. Thus, we aimed to identify memory impairment and GM atrophy and explore the possible correlation between them in patients with asymptomatic severe CAS.MethodsTwenty-four patients with asymptomatic severe CAS and 10 healthy controls completed the mini-mental state examination (MMSE) and clinical memory scale (CMS) and underwent 7T magnetic resonance imaging (MRI) scan. Field intensity inhomogeneities were corrected. Images were processed using VBM8, and GM images were flipped. First, 11 flipped and 10 non-flipped images of patients with unilateral CAS and 5 flipped and 5 non-flipped images of controls were pre-processed using DARTEL algorithm and analyzed using an analysis of variance (ANOVA). Second, flipped and non-flipped images of unilateral patients were similarly pre-processed and analyzed using the paired t-test. Third, pre-processed non-flipped GM images and CMS scores of 24 patients were analyzed by multiple regression analysis. Nuisance variables were corrected accordingly.ResultsBasic information was well matched between patients and controls. MMSE scores of patients were in the normal range; however, memory function was significantly reduced (all P < 0.05). GM volumes of patients were significantly reduced in the anterior circulation regions. The stenosis-side hemispheres showed greater atrophy. GM volumes of the left pars opercularis, pars triangularis, and middle frontal gyrus were strongly positively correlated with the total scores of CMS (all r > 0.7, P = 0.001). Additionally, the left middle frontal gyrus was strongly positively correlated with associative memory (r = 0.853, P = 0.001). The left pars opercularis was moderately positively correlated with semantic memory (r = 0.695, P = 0.001).ConclusionPatients with asymptomatic CAS suffer from memory impairment. Bilateral anterior circulation regions showed extensive atrophy. The hemisphere with stenosis showed severer atrophy. Memory impairment in patients may be related to atrophy of the left frontal gyrus and atrophy of different regions may result in different memory impairments.

Basilar Apex Aneurysms in the Setting of Carotid Artery Stenosis: Case Series and Angiographic Anatomic Study

2019 ◽  
Vol 16 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Mihael D. Rosenbaum ◽  
Daniel M. Heiferman ◽  
Osama A. Raslan ◽  
Brendan Martin ◽  
Jose F. Dominguez ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Case Series ◽  
Posterior Circulation ◽  
Artery Stenosis ◽  
Anatomic Study ◽  
Anterior Circulation ◽  
Aneurysm Neck ◽  
Symptomatic Carotid ◽  
Life Threatening

Background: Intracranial aneurysms (IAs) are life-threatening lesions known within the literature to be found incidentally during routine angiographic workup for carotid artery stenosis (CAS). As IAs are associated with vascular shear stress, it is reasonable to expect that altered flow demands within the anterior circulation, such as with CAS, increase compensatory flow demands via the Circle of Willis (COW) and may induce similar stress at the basilar apex. Objective: We present a series of nine unruptured basilar apex aneurysms (BAA) with CAS and a comparative radiographic analysis to BAA without CAS. Methods: Twenty-three patients with BAA were retrospectively identified using records from 2011 to 2016. CAS by North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, morphology of BAA, competency of COW, and anatomic relationships within the posterior circulation were examined independently by a neuroradiologist using angiographic imaging. Results: Nine (39%) of the twenty-three BAA patients had CAS, with six having stenosis ≥50%. Four (67%) of the patients with ≥50% CAS demonstrated aneurysm flow angles contralateral to the side with highest CAS. Additionally, the angle between the basilar artery (BA) trajectory and aneurysm neck was observed to be smaller in patients with ≥50% CAS (61 vs 74 degrees). No significant differences in COW patency, posterior circulation morphology, and degree of stenosis were observed. Conclusion: Changes in the cervical carotid arteries may lead to blood flow alterations in the posterior circulation that increase the propensity for BAA formation. Posterior circulation imaging can be considered in CAS patients to screen for BAA.

scholarly journals Plaque Length Predicts the Incidence of Microembolic Signals in Acute Anterior Circulation Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Liming Zhao ◽  
Hongqin Zhao ◽  
Yicheng Xu ◽  
Aijuan Zhang ◽  
Jiatang Zhang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Plaque ◽  
Intima Media Thickness ◽  
Roc Curves ◽  
Cross Sectional Study ◽  
Artery Stenosis ◽  
Anterior Circulation ◽  
Cross Sectional ◽  
The Relationship

Microembolic signals (MES) of the carotid artery are associated with plaque destabilization and reoccurrence of stroke. Previous studies have focused primarily on the degree of carotid artery stenosis and plaque components, and the relationship between plaque length and microembolic sign has received little attention. We aimed to find the association between carotid plaque length (CPL) and the presence of MES. We conducted a retrospective observational cross-sectional study. A total of 84 acute anterior-circulation ischemic stroke/transient ischemic attack (TIA) patients with carotid artery atherosclerosis were classified into an MES-positive (MES+) group and MES-negative (MES−) group. We measured multiple parameters of carotid plaque size (length, thickness) in each patient and evaluated the relationship between different plaque parameters and occurrence of MES. We found that male, carotid artery stenosis (CAS), CPL, carotid plaque thickness (CPT), and intima-media thickness (IMT) of the carotid artery were each significantly different between two groups (all P < 0.05 ). The multivariate analysis showed CPL (odds ratio (OR), 1.109; 95% CI, 1.044–1.177; P = 0.001 ) to be independently associated with the presence of MES. The areas under the ROC curves (AUCs) for CPL for predicting MES were 0.777 (95% CI, 0.640–0.914; P < 0.001 ). The cutoff value of CPL for predicting MES was 16.7 mm, with a sensitivity of 88.2% and a specificity of 77.6%. We found that CPL was a meaningful independent predictor of MES. Therefore, CPL may be useful for risk stratification of long and nonstenotic plaques in anterior circulation stroke.

Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 268-274
Author(s):  
Erhan Saraçoğlu ◽  
Ertan Vuruşkan ◽  
Yusuf Çekici ◽  
Salih Kiliç ◽  
Halil Ay ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carotid Artery ◽  
Oxidative Damage ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Oxidative Stress Marker ◽  
Asymptomatic Carotid ◽  
Imaging Methods ◽  
Neurological Findings ◽  
Asymptomatic Carotid Artery Stenosis

Abstract. Background: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis. Patients and methods: We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. Results: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). Conclusions: We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.

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