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Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis
- Source :
- Journal of Neurology. 265:151-158
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Aortic atheroma is a known cause of ischemic stroke. However, it is unclear whether ischemic stroke is caused by emboli from aortic atheroma or by accompanying atherosclerosis. In this study, we evaluated lesion patterns of patients with complex aortic plaque (CAP) to assume the underlying pathophysiology. Acute ischemic stroke patients who underwent transesophageal echocardiography were included. CAP was defined as a plaque in the proximal aorta ≥ 4 mm thick or with a mobile component. The diffusion-weighted imaging lesion patterns of patients with CAP were compared to those with large arterial atherosclerosis (LAA) or cardioembolism (CE). A total of 64 CAP patients, 127 LAA patients, and 80 CE patients were included. Small cortical pattern was more common in the CAP group (45.3%) than in the LAA (7.9%, p < 0.001) or the CE group (23.8%, p = 0.018). A large cortical pattern was more common in the CE group than in the CAP group (p < 0.001), whereas subcortical only pattern tended to be more common in the CAP group than in the CE group (p = 0.057). In multinominal analysis, the CAP group was more likely to have a small cortical lesion than the LAA group [odds ratio (OR) 14.63; 95% confidence interval (CI) 4.67–45.85] or the CE (OR 3.69, 95% CI 1.19–11.39) group. In conclusion, patients with CAP frequently had small cortical lesions or subcortical single lesion. These findings imply that ischemic stroke in aortic atheroma patients is associated with either small emboli or small artery disease.
- Subjects :
- Carotid Artery Diseases
Male
medicine.medical_specialty
Neurology
Embolism
Infarction
030204 cardiovascular system & hematology
Statistics, Nonparametric
Lesion
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine.artery
medicine
Humans
Aged
Retrospective Studies
Neuroradiology
Cerebral Cortex
Aorta
business.industry
Arteries
Odds ratio
Middle Aged
medicine.disease
Plaque, Atherosclerotic
Pathophysiology
Confidence interval
Stroke
Diffusion Magnetic Resonance Imaging
Cardiology
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14321459 and 03405354
- Volume :
- 265
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology
- Accession number :
- edsair.doi.dedup.....5f669b6fc26a11cdcdf91b81cddb3439