OBJECTIVES: The aim of this study was to determine whether unstable carotid plaques, a known risk factor for cerebral emboli, are associated with cerebral white matter lesions. METHODS: Seventy-one symptomatic patients undergoing magnetic resonance imaging prior to carotid endarterectomy for high grade carotid stenosis were included in this study. The number and volume of white matter hyperintense lesions (WMHL) on fluid attenuated inversion recovery brain scans were compared according to the morphology of carotid plaque based upon the American Heart Association (AHA) histological classification. RESULTS: Of the 57 patients who had good quality brain scans and non-fragmented carotid plaques, 15 plaques were defined as stable (type V) and 42 as unstable (type VI). After adjustment for the major risk factors affecting WMHL, unstable carotid plaques were found to be associated with more WMHL in the ipsilateral cerebral hemisphere than stable plaques (transformed means 2.50+/-1.2 vs. 1.53+/-1.1, p=0.016), however, there was only a trend towards larger WMHL volumes (p=0.079). CONCLUSIONS: The observed association between unstable carotid plaques and the number of white matter lesions suggest that thromboembolic plaque activity may contribute to the development of leukoaraiosis, in particular smaller individual lesions. Larger studies are warranted to confirm this finding and explore the potential clinical impact for selecting candidates for carotid endarterectomy.
OBJECTIVES: The aim of this study was to determine whether unstable carotid plaques, a known risk factor for cerebral emboli, are associated with cerebral white matter lesions. METHODS: Seventy-one symptomatic patients undergoing magnetic resonance imaging prior to carotid endarterectomy for high grade carotid stenosis were included in this study. The number and volume of white matter hyperintense lesions (WMHL) on fluid attenuated inversion recovery brain scans were compared according to the morphology of carotid plaque based upon the American Heart Association (AHA) histological classification. RESULTS: Of the 57 patients who had good quality brain scans and non-fragmented carotid plaques, 15 plaques were defined as stable (type V) and 42 as unstable (type VI). After adjustment for the major risk factors affecting WMHL, unstable carotid plaques were found to be associated with more WMHL in the ipsilateral cerebral hemisphere than stable plaques (transformed means 2.50+/-1.2 vs. 1.53+/-1.1, p=0.016), however, there was only a trend towards larger WMHL volumes (p=0.079). CONCLUSIONS: The observed association between unstable carotid plaques and the number of white matter lesions suggest that thromboembolic plaque activity may contribute to the development of leukoaraiosis, in particular smaller individual lesions. Larger studies are warranted to confirm this finding and explore the potential clinical impact for selecting candidates for carotid endarterectomy.
Authors: Vivek Prabhakaran; Veena A Nair; Benjamin P Austin; Christian La; Thomas A Gallagher; Yijing Wu; Donald G McLaren; Guofan Xu; Patrick Turski; Howard Rowley Journal: Neuroimaging Clin N Am Date: 2012-05 Impact factor: 2.264
Authors: K Yamada; Y Nagakane; H Sasajima; M Nakagawa; K Mineura; T Masunami; K Akazawa; T Nishimura Journal: AJNR Am J Neuroradiol Date: 2008-03-05 Impact factor: 3.825
Authors: Jörg Ederle; Indran Davagnanam; H Bart van der Worp; Graham S Venables; Philippe A Lyrer; Roland L Featherstone; Martin M Brown; H Rolf Jäger Journal: Lancet Neurol Date: 2013-07-12 Impact factor: 44.182
Authors: Niku Oksala; Marianne Jaroma; Juha-Pekka Pienimäki; Tommi Kuorilehto; Teemu Vänttinen; Antti Lehtomäki; Veli-Pekka Suominen; Prasun Dastidar; Kimmo Mäkinen; Timo Erkinjuntti; Juha-Pekka Salenius Journal: Cerebrovasc Dis Extra Date: 2014-06-07