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Isolated MCA disease in patients without significant atherosclerotic risk factors: a high-resolution magnetic resonance imaging study.
- Source :
-
Stroke [Stroke] 2015 Mar; Vol. 46 (3), pp. 697-703. Date of Electronic Publication: 2015 Jan 27. - Publication Year :
- 2015
-
Abstract
- Background and Purpose: Diagnosis of intracranial artery atherosclerosis remains often uncertain. The high-resolution magnetic resonance imaging (HR-MRI) enables vessel wall assessment for more precise diagnoses. The aim of the present study was to investigate the etiologies of middle cerebral artery steno-occlusive disease in young adult patients with few atherosclerotic risk factors using HR-MRI.<br />Methods: We prospectively studied patients who visited a tertiary hospital in Seoul, Korea, and had (1) unilateral middle cerebral artery disease (≥50% stenosis or occlusion), (2) were ≤55 years old and had no or minimal (≤1) atherosclerotic risk factors. We excluded patients with a confirmed diagnosis of Moyamoya disease, vasculitis, or dissection and those having emboligenic sources. A presumptive diagnosis was made based on HR-MRI findings, and patients were categorized as HR-athero (atherosclerotic disease), HR-MMD (Moyamoya disease), HR-dissection, or HR-vasculitis.<br />Results: Among 95 patients analyzed, 26 (27.4%) had HR-athero who were more often male (P=0.004), smokers (P=0.018), and had focal stenosis (P=0.003) than others.As compared with the HR-athero patients, 29 HR-MMD patients were more often female (P<0.001) and more often had occlusive lesions (P=0.001) and nonfocal stenosis (P<0.001). The 22 HR-dissection patients tended to have hypertension less often, and the 13 HR-vasculitis patients were younger (P=0.004) and tended to have nonfocal stenosis. [corrected].<br />Conclusions: In our cohort of young patients with minimal risk factors, atherosclerosis seems to be an uncommon pathology of middle cerebral artery stenosis. HR-MRI aids us to make a more reliable diagnosis.<br /> (© 2015 American Heart Association, Inc.)
- Subjects :
- Adult
Cerebral Angiography
Constriction, Pathologic physiopathology
Female
Humans
Intracranial Arteriosclerosis diagnosis
Male
Middle Aged
Prospective Studies
Republic of Korea
Risk Factors
Smoking
Tertiary Care Centers
Treatment Outcome
Intracranial Arteriosclerosis physiopathology
Magnetic Resonance Imaging methods
Middle Cerebral Artery pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 46
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 25628303
- Full Text :
- https://doi.org/10.1161/STROKEAHA.114.008181