Ayeesha K Kamal1, Farzin Majeed2, Muhammad S Ilyas3, Munawar Hussain4, Kamran Masood4, Bilal Ahmed5, Hasan Rehman6, Zafar Sajjad7, Scott E Kasner8. 1. Department of Neurology and Stroke Service, Aga Khan University, Pakistan. 2. Fogarty Cerebrovascular Research Fellow, Aga Khan University, Pakistan. 3. Department of Neurology, Dow University of Health Sciences, Pakistan. 4. Department of Radiology, Dow University of Health Sciences, Pakistan. 5. Department of Epidemiology and Biostatistics, Aga Khan University, Pakistan. 6. Department of Medicine, Aga Khan University, Pakistan. 7. Department of Radiology, Aga Khan University, Pakistan. 8. Department of Neurology, University of Pennsylvania, USA.
Abstract
BACKGROUND: Intracranial atherosclerotic disease (ICAD) is the most common ischemic stroke subtype globally. It accounts for 30-50% of all ischemic strokes in Asians. AIMS: The aim of the study is to report the frequency of asymptomatic ICAD and its associated Magnetic Resonance Imaging (MRI) findings. METHODS: 200 adult participants were recruited from the Radiology Departments of two major diagnostic centers in Karachi. Eligible participants were confirmed for the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS). QVSFS negative subjects underwent MRI on a 1.5 Tesla scanner. Images were centrally reviewed on Di com Viewer 3.0 with electronic calipers to calculate the degree of ICAD. RESULTS: Mean age of subjects was 37.1 years (S.D 15.1) with 50.5% men (n=101) and 49.5% women (n=99). Asymptomatic ICAD was found in 34.5% (n=69) subjects. Of the 3800 intracranial arteries studied, 2.2% (n=88) had biological disease. 20.5% (n=18) of these vessels had atherosclerotic irregularities, 43.2% (n=38) had mild stenos is, 11.4% (n=10) had moderate stenos is, 5.7% (n=5) had severe stenos is while 19.3% (n=17) were completely occluded. The posterior cerebral artery (42% of stenosed arteries, n=37) was most affected. 23.5% (n=47) of subjects had peri-ventricular lucencies, 10.5% (n=21) had brain atrophy while 3.5% (n=7) had silent brain infarcts. There was a significant association between asymptomatic ICAD and peri ventricular lucencies (PR 1.59; 95% CI 1.35-1.99). CONCLUSION: Asymptomatic ICAD is common in young Pakistanis, with no gender predilection; it preferentially affects the posterior circulation. Silent infarcts are rare compared to peri ventricular lucencies and atrophy.
BACKGROUND:Intracranial atherosclerotic disease (ICAD) is the most common ischemic stroke subtype globally. It accounts for 30-50% of all ischemic strokes in Asians. AIMS: The aim of the study is to report the frequency of asymptomatic ICAD and its associated Magnetic Resonance Imaging (MRI) findings. METHODS: 200 adult participants were recruited from the Radiology Departments of two major diagnostic centers in Karachi. Eligible participants were confirmed for the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS). QVSFS negative subjects underwent MRI on a 1.5 Tesla scanner. Images were centrally reviewed on Di com Viewer 3.0 with electronic calipers to calculate the degree of ICAD. RESULTS: Mean age of subjects was 37.1 years (S.D 15.1) with 50.5% men (n=101) and 49.5% women (n=99). Asymptomatic ICAD was found in 34.5% (n=69) subjects. Of the 3800 intracranial arteries studied, 2.2% (n=88) had biological disease. 20.5% (n=18) of these vessels had atherosclerotic irregularities, 43.2% (n=38) had mild stenos is, 11.4% (n=10) had moderate stenos is, 5.7% (n=5) had severe stenos is while 19.3% (n=17) were completely occluded. The posterior cerebral artery (42% of stenosed arteries, n=37) was most affected. 23.5% (n=47) of subjects had peri-ventricular lucencies, 10.5% (n=21) had brain atrophy while 3.5% (n=7) had silent brain infarcts. There was a significant association between asymptomatic ICAD and peri ventricular lucencies (PR 1.59; 95% CI 1.35-1.99). CONCLUSION: Asymptomatic ICAD is common in young Pakistanis, with no gender predilection; it preferentially affects the posterior circulation. Silent infarcts are rare compared to peri ventricular lucencies and atrophy.
Authors: Maria Khan; Asif Rasheed; Saman Hashmi; Moazzam Zaidi; Muhammad Murtaza; Saba Akhtar; Lajpat Bansari; Nabi Shah; Maria Samuel; Sadaf Raza; Umer Rais Khan; Bilal Ahmed; Bilawal Ahmed; Naveeduddin Ahmed; Jamal Ara; Tasnim Ahsan; S M Munir; Shoukat Ali; Khalid Mehmood; Karim Ullah Makki; Muhammad Masroor Ahmed; Niaz Sheikh; Abdul Rauf Memon; Philippe M Frossard; Ayeesha Kamran Kamal Journal: Int J Stroke Date: 2012-09-27 Impact factor: 5.266
Authors: Hai Wei Huang; Ming Hui Guo; Rui Jin Lin; Ya Li Chen; Qin Luo; Ying Zhang; Ka Sing Wong Journal: Cerebrovasc Dis Date: 2007-05-23 Impact factor: 2.762