BACKGROUND AND PURPOSE: Few community-based studies investigating young adult strokes exist. The aim of this study was to determine the diagnostic yield of head and neck CTA in evaluation of anterior circulation ischemic stroke in young adults. MATERIALS AND METHODS: This retrospective review is limited to patients between the ages of 18-50 presenting to the Mayo Clinic Rochester emergency department or referred from smaller institutions in adjacent counties. Patients with posterior circulation infarcts, amaurosis fugax, central retinal artery occlusion or transient ischemic attacks were excluded. The presence of carotid dissection, webs, plaque, or other high-risk lesions were recorded. RESULTS: A total of 136 patients met inclusion criteria. Mean degree of carotid stenosis ipsilateral to infarct was 14.1%, compared to 6.5% on the contralateral side (p = .006). Ipsilateral mean carotid wall thickness measured .79 mm, compared to contralateral thickness of .80 mm (p = .51). Ipsilateral low-density plaque was observed in 22 patients (16.2%), and 21 patients (15.4%) on the contralateral side (p = .87). Ipsilateral calcified plaque was observed in 37 patients (27.2%), and 29 patients (21.3%) on the contralateral side (p = .31). 20 (14.7%) ipsilateral dissections were noted, compared to 4 (2.9%) contralateral dissections (p = .001). 3 (2.2%) ipsilateral carotid webs were identified, compared to 0 contralateral webs (p = .25). CONCLUSION: Carotid dissection was the most common cause of anterior circulation infarct identified on cervical CTA in this population. Carotid webs and atherosclerosis were not common findings.
BACKGROUND AND PURPOSE: Few community-based studies investigating young adult strokes exist. The aim of this study was to determine the diagnostic yield of head and neck CTA in evaluation of anterior circulation ischemic stroke in young adults. MATERIALS AND METHODS: This retrospective review is limited to patients between the ages of 18-50 presenting to the Mayo Clinic Rochester emergency department or referred from smaller institutions in adjacent counties. Patients with posterior circulation infarcts, amaurosis fugax, central retinal artery occlusion or transient ischemic attacks were excluded. The presence of carotid dissection, webs, plaque, or other high-risk lesions were recorded. RESULTS: A total of 136 patients met inclusion criteria. Mean degree of carotid stenosis ipsilateral to infarct was 14.1%, compared to 6.5% on the contralateral side (p = .006). Ipsilateral mean carotid wall thickness measured .79 mm, compared to contralateral thickness of .80 mm (p = .51). Ipsilateral low-density plaque was observed in 22 patients (16.2%), and 21 patients (15.4%) on the contralateral side (p = .87). Ipsilateral calcified plaque was observed in 37 patients (27.2%), and 29 patients (21.3%) on the contralateral side (p = .31). 20 (14.7%) ipsilateral dissections were noted, compared to 4 (2.9%) contralateral dissections (p = .001). 3 (2.2%) ipsilateral carotid webs were identified, compared to 0 contralateral webs (p = .25). CONCLUSION: Carotid dissection was the most common cause of anterior circulation infarct identified on cervical CTA in this population. Carotid webs and atherosclerosis were not common findings.
Authors: Kars C J Compagne; Ad C G M van Es; Olvert A Berkhemer; Jordi Borst; Yvo B W E M Roos; Robert J van Oostenbrugge; Wim H van Zwam; Charles B L M Majoie; Henk A Marquering; Diederik W J Dippel; Aad van der Lugt; Bart J Emmer Journal: Radiology Date: 2017-10-16 Impact factor: 11.105
Authors: P M C Choi; D Singh; A Trivedi; E Qazi; D George; J Wong; A M Demchuk; M Goyal; M D Hill; B K Menon Journal: AJNR Am J Neuroradiol Date: 2015-07-30 Impact factor: 3.825
Authors: Vincent C Cappendijk; Alfons G H Kessels; Sylvia Heeneman; Kitty B J M Cleutjens; Geert Willem H Schurink; Rob J Th J Welten; Werner H Mess; Robert-Jan van Suylen; Tim Leiner; Mat J A P Daemen; Jos M A van Engelshoven; M Eline Kooi Journal: J Magn Reson Imaging Date: 2008-06 Impact factor: 4.813