scholarly journals Correlation Between Internal Carotid Artery Tortuosity and Imaging of Cerebral Small Vessel Disease

2020 ◽  
Vol 11 ◽  
Author(s):  
Yuan-Chang Chen ◽  
Xiao-Er Wei ◽  
Jing Lu ◽  
Rui-Hua Qiao ◽  
Xue-Feng Shen ◽  
...  
Aging ◽  
2021 ◽  
Author(s):  
Dan-Hong Zhang ◽  
Jiao-Lei Jin ◽  
Cheng-Fei Zhu ◽  
Qiu-Yue Chen ◽  
Xin-Wei He

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Ryosuke Doijiri ◽  
Kozue Saito ◽  
Rie Motoyama ◽  
Yukiko Tsutsumi ◽  
Shinichiro Uchiyama ◽  
...  

Background and Purpose: Lacunar infarction and intracerebral hemorrhage (ICH) are closely related. Although they are classified as different stroke subtypes, both are associated with cerebral small-vessel disease (CSVD). Previous studies showed a positive correlation of CSVD with physiological parameters such as pulse wave velocity (PWV) or with radiographical findings such as cerebral microbleeds (CMB); however, the role of these parameters remains controversial. Therefore, we assessed whether there is a relationship between stroke subtypes and these potential CSVD-related parameters. Methods: In a multicenter, prospective study from 8 hospitals, we enrolled 342 patients with a history of cerebral infarction or ICH who underwent both carotid ultrasound and MRI examination between February 2011 and December 2012. Ischemic stroke subtypes were determined based on the Trial of Org 10172 in Acute Stroke Treatment criteria, and patients with small vessel occlusion (SVO) or large artery atherosclerosis (LAA) were included in this study. We evaluated the PWV, ultrasonographic parameters [max-IMT, plaque score, pulsatility index (PI), and the diameter of common carotid artery (CCA)], and MRI findings [periventricular hyperintensity (PVH) and CMB]. The severity of PVH was determined according to the Fazekas classification. Results: Of 342 patients, 130 (38%) were classified into the LAA group, 64 (19%) into the ICH group, and 148 (43%) into the SVO group. There were no significant differences in the parameters between the SVO and ICH groups; however, the parameters of the SVO or ICH groups were different from those of the LAA group. After adjustment for vascular risk factors, the following parameters in both SVO and ICH groups were significantly different from those in the LAA group: lower plaque score, higher PI of the internal carotid artery (ICA), higher PVH grade, and greater CMB frequency. Conclusion: The SVO and ICH groups showed alterations in imaging parameters reflecting the underlying pathophysiology of CSVD, including lower plaque score, higher PI of ICA, greater CMB frequency, and higher PVH grade, compared with those of the LAA group.


2021 ◽  
Vol 12 ◽  
Author(s):  
Nicholas R. Evans ◽  
Jason M. Tarkin ◽  
Jessica Walsh ◽  
Mohammed M. Chowdhury ◽  
Andrew J. Patterson ◽  
...  

Background: Atherosclerosis is a systemic inflammatory disease, with common inflammatory processes implicated in both atheroma vulnerability and blood-brain barrier disruption. This prospective multimodal imaging study aimed to measure directly the association between systemic atheroma inflammation (“atheroinflammation”) and downstream chronic cerebral small vessel disease severity.Methods: Twenty-six individuals with ischemic stroke with ipsilateral carotid artery stenosis of >50% underwent 18fluoride-fluorodeoxyglucose-positron emission tomography within 2 weeks of stroke. Small vessel disease severity and white matter hyperintensity volume were assessed using 3-tesla magnetic resonance imaging also within 2 weeks of stroke.Results: Fluorodeoxyglucose uptake was independently associated with more severe small vessel disease (odds ratio 6.18, 95% confidence interval 2.1–18.2, P < 0.01 for the non-culprit carotid artery) and larger white matter hyperintensity volumes (coefficient = 14.33 mL, P < 0.01 for the non-culprit carotid artery).Conclusion: These proof-of-concept results have important implications for our understanding of the neurovascular interface and potential therapeutic exploitation in the management of systemic atherosclerosis, particularly non-stenotic disease previously considered asymptomatic, in order to reduce the burden of chronic cerebrovascular disease.


2020 ◽  
Vol 5 (2) ◽  
pp. 128-137
Author(s):  
Huimin Chen ◽  
Yuesong Pan ◽  
Lixia Zong ◽  
Jing Jing ◽  
Xia Meng ◽  
...  

BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589


2021 ◽  
pp. 0271678X2199262
Author(s):  
Shuai Jiang ◽  
Tian Cao ◽  
Yuying Yan ◽  
Tang Yang ◽  
Ye Yuan ◽  
...  

Recent subcortical infarction (RSI) in the lenticulostriate artery (LSA) territory with a non-stenotic middle cerebral artery is a heterogeneous entity. We aimed to investigate the role of LSA combined with neuroimaging markers of cerebral small vessel disease (CSVD) in differentiating the pathogenic subtypes of RSI by whole-brain vessel-wall magnetic resonance imaging (WB-VWI). Fifty-two RSI patients without relevant middle cerebral artery (MCA) stenosis on magnetic resonance angiography were prospectively enrolled. RSI was dichotomized as branch atheromatous disease (BAD; a culprit plaque located adjacent to the LSA origin) (n = 34) and CSVD-related lacunar infarction (CSVD-related LI; without plaque or plaque located distal to the LSA origin) (n = 18). Logistic regression analysis showed lacunes (odds ratio [OR] 9.68, 95% confidence interval [CI] 1.71–54.72; P = 0.010) and smaller number of LSA branches (OR 0.59, 95% CI 0.36–0.96; P = 0.034) were associated with of BAD, whereas severe deep white matter hyperintensities (DWMH) (OR 0.11, 95% CI 0.02–0.71; P = 0.021) was associated with CSVD-related LI. In conclusion, the LSA branches combined with lacunes and severe DWMH may delineate subtypes of SSI. The WB-VWI technique could be a credible tool for delineating the heterogeneous entity of SSI in the LSA territory.


2021 ◽  
pp. 1-4
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera

A total of 590 older adults of Amerindian ancestry living in rural Ecuador received anthropometric measurements and a brain magnetic resonance imaging to estimate the total cerebral small vessel disease (cSVD) score. A fully adjusted ordinal logistic regression model, with categories of the total cSVD score as the dependent variable, disclosed significant associations between the waist circumference, the waist-to-hip, and the waist-to-height ratios – but not the body mass index (BMI) – and the cSVD burden. Indices of abdominal obesity may better correlate with severity of cSVD than the BMI in Amerindians. Phenotypic characteristics of this population may account for these results.


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