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Clinical, imaging features and outcome in internal carotid artery versus middle cerebral artery disease


Autoři: Changqing Zhang aff001;  Yilong Wang aff001;  Xingquan Zhao aff001;  Liping Liu aff001;  ChunXue Wang aff001;  Zixiao Li aff001;  Yuehua Pu aff001;  Xinying Zou aff001;  Yuesong Pan aff002;  Yongjun Wang aff001
Působiště autorů: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China aff001;  China National Clinical Research Center for Neurological Diseases, Beijing, China aff002;  Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China aff003;  Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0225906

Souhrn

Background

Only a very few studies had compared the differences in topographic patterns of cerebral infarcts between middle cerebral artery (MCA) and internal carotid artery (ICA) disease. Besides, the comparison of clinical features and outcomes between MCA and ICA disease had rarely been reported.

Objectives

To compare the clinical, imaging features and outcome of MCA versus ICA disease.

Methods

We prospectively enrolled 1172 patients with noncardiogenic ischemic stroke in ipsilateral ICA or MCA territory. Clinical, neuroradiologic and outcome of the two groups were compared in this observational cohort study.

Results

The ICA group more frequently presented with decreased alertness, gaze palsy, aphasia, and neglect than the MCA group at admission, and more often had higher National Institute of Health stroke scale score at admission and discharge. Meanwhile, the ICA group more frequently had multiple acute infarcts, watershed infarcts, territorial infarct, small cortical infarct, and responsible artery stenosis ≥70%. Whereas penetrating artery infarct and parent artery occluding penetrating artery was more often associated with MCA disease. The ICA group more frequently had inhospital complications of pneumonia and deep vein thrombosis, more often had disability at discharge, and had more recurrent ischemic stroke or transient ischemic attack in 1 Year. Multivariable logistic regression identified male (OR, 1.99; 95% CI, 1.30 to 3.05; P = 0.002), history of coronary heart disease (OR, 1.85; 95% CI, 1.03 to 3.32; P = 0.041), multiple acute infarcts (OR, 4.18; 95% CI, 2.07 to 8.45; P<0.0001), and territorial infarct (OR, 2.23; 95% CI, 1.52 to 3.27; P<0.0001) was more often associated with ICA territory disease.

Conclusions

The clinical, radiologic characteristics and outcome are distinctively different between ICA and MCA disease. Compared to MCA disease, ICA disease has more serious clinical and radiologic manifestation, and poorer outcome.

Klíčová slova:

stroke – Ischemic stroke – Magnetic resonance imaging – Coronary heart disease – Stenosis – Arteries – Carotid arteries – Cerebral arteries


Zdroje

1. White H, Boden-Albala B, Wang C, Elkind MS, Rundek T, Wright CB, et al. Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study. Circulation. 2005;111(10):1327–31. doi: 10.1161/01.CIR.0000157736.19739.D0 15769776

2. Feldmann E, Daneault N, Kwan E, Ho KJ, Pessin MS, Langenberg P, et al. Chinese-white differences in the distribution of occlusive cerebrovascular disease. Neurology. 1990;40(10):1541–5. doi: 10.1212/wnl.40.10.1540 2215945

3. Pu Y, Liu L, Wang Y, Zou X, Pan Y, Soo Y, et al. Geographic and sex difference in the distribution of intracranial atherosclerosis in China. Stroke. 2013;44(8):2109–14. doi: 10.1161/STROKEAHA.113.001522 23760212

4. Wong KS, Gao S, Chan YL, Hansberg T, Lam WW, Droste DW, et al. Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis: a diffusion-weighted imaging and microemboli monitoring study. Annals of neurology. 2002;52(1):74–81. doi: 10.1002/ana.10250 12112050

5. Kang DW, Chu K, Ko SB, Kwon SJ, Yoon BW, Roh JK. Lesion patterns and mechanism of ischemia in internal carotid artery disease: a diffusion-weighted imaging study. Archives of neurology. 2002;59(10):1577–82. doi: 10.1001/archneur.59.10.1577 12374495

6. Szabo K, Kern R, Gass A, Hirsch J, Hennerici M. Acute stroke patterns in patients with internal carotid artery disease: a diffusion-weighted magnetic resonance imaging study. Stroke. 2001;32(6):1323–9. doi: 10.1161/01.str.32.6.1323 11387494

7. Lee PH, Oh SH, Bang OY, Joo SY, Joo IS, Huh K. Infarct patterns in atherosclerotic middle cerebral artery versus internal carotid artery disease. Neurology. 2004;62(8):1291–6. doi: 10.1212/01.wnl.0000120761.57793.28 15111664

8. Tatu L, Moulin T, Vuillier F, Bogousslavsky J. Arterial territories of the human brain. Frontiers of neurology and neuroscience. 2012;30:99–110. doi: 10.1159/000333602 22377874

9. Lee DK, Kim JS, Kwon SU, Yoo SH, Kang DW. Lesion patterns and stroke mechanism in atherosclerotic middle cerebral artery disease: early diffusion-weighted imaging study. Stroke. 2005;36(12):2583–8. doi: 10.1161/01.STR.0000189999.19948.14 16269637

10. Samuels OB, Joseph GJ, Lynn MJ, Smith HA, Chimowitz MI. A standardized method for measuring intracranial arterial stenosis. AJNR American journal of neuroradiology. 2000;21(4):643–6. 10782772

11. Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD, Bluth EI, et al. Carotid artery stenosis: grayscale and Doppler ultrasound diagnosis—Society of Radiologists in Ultrasound consensus conference. Ultrasound quarterly. 2003;19(4):190–8. doi: 10.1097/00013644-200312000-00005 14730262

12. Fox AJ. How to measure carotid stenosis. Radiology. 1993;186(2):316–8. doi: 10.1148/radiology.186.2.8421726 8421726

13. D'Amore C, Paciaroni M. Border-zone and watershed infarctions. Frontiers of neurology and neuroscience. 2012;30:181–4. doi: 10.1159/000333638 22377891

14. Ay H, Furie KL, Singhal A, Smith WS, Sorensen AG, Koroshetz WJ. An evidence-based causative classification system for acute ischemic stroke. Annals of neurology. 2005;58(5):688–97. doi: 10.1002/ana.20617 16240340

15. Gao S, Wang YJ, Xu AD, Li YS, Wang DZ. Chinese ischemic stroke subclassification. Front Neurol. 2011;2:6. doi: 10.3389/fneur.2011.00006 21427797

16. Ois A, Gomis M, Rodriguez-Campello A, Cuadrado-Godia E, Jimenez-Conde J, Pont-Sunyer C, et al. Factors associated with a high risk of recurrence in patients with transient ischemic attack or minor stroke. Stroke. 2008;39(6):1717–21. doi: 10.1161/STROKEAHA.107.505438 18369168

17. Kim JM, Jung KH, Sohn CH, Moon J, Han MH, Roh JK. Middle cerebral artery plaque and prediction of the infarction pattern. Archives of neurology. 2012;69(11):1470–5. doi: 10.1001/archneurol.2012.1018 22910889

18. Yong SW, Bang OY, Lee PH, Li WY. Internal and cortical border-zone infarction: clinical and diffusion-weighted imaging features. Stroke. 2006;37(3):841–6. doi: 10.1161/01.STR.0000202590.75972.39 16424374

19. Tamura A, Yamamoto Y, Nagakane Y, Takezawa H, Koizumi T, Makita N, et al. The relationship between neurological worsening and lesion patterns in patients with acute middle cerebral artery stenosis. Cerebrovasc Dis. 2013;35(3):268–75. doi: 10.1159/000348313 23548833

20. Mangla R, Kolar B, Almast J, Ekholm SE. Border zone infarcts: pathophysiologic and imaging characteristics. Radiographics: a review publication of the Radiological Society of North America, Inc. 2011;31(5):1201–14. doi: 10.1148/rg.315105014 21918038

21. Homburg PJ, Rozie S, van Gils MJ, Jansen T, de Weert TT, Dippel DW, et al. Atherosclerotic plaque ulceration in the symptomatic internal carotid artery is associated with nonlacunar ischemic stroke. Stroke. 2010;41(6):1151–6. doi: 10.1161/STROKEAHA.109.576256 20413739

22. Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ, et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet. 2011;377(9765):568–77. doi: 10.1016/S0140-6736(10)62036-3 21295844

23. Wang J, Zhang L, Wang F, Liu L, Wang H, China National Survey of Chronic Kidney Disease Working G. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens. 2014;27(11):1355–61. doi: 10.1093/ajh/hpu053 24698853

24. Gorelick P, Wong KS, Liu L. Epidemiology. Frontiers of neurology and neuroscience. 2016;40:34–46. doi: 10.1159/000448272 27960190


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