COMPARISON OF EXTRACRANIAL WITH INTRACRANIAL CAROTID ARTERY DISEASE IN ISCHAEMIC STROKE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 13
Abstract
BACKGROUND Atherosclerotic intracranial large artery stenosis accounts for 20% of ischaemic stroke. Embolism from major arteries is a common source of stroke. The incidence and prevalence of the condition varies accordingly to the population studied. This study compares the concordance and discordance of extracranial and intracranial carotid artery disease in patients with anterior circulation ischaemic stroke by using Doppler ultrasound study, which is a non-invasive study, since most of the studies which compare the intracranial and extracranial atherosclerotic disease are invasive. MATERIALS AND METHODS This cross-sectional study was conducted during Jan. 2011 to Oct. 2013 at Madras Institute of Neurology, Rajiv Gandhi Government General Hospital, Chennai. Patients with clinical features suggestive of stroke were enrolled in this study. All were subjected to CT Brain, MRI Brain and Carotid Doppler. Patients with extracranial carotid stenosis were enrolled and subjected to transcranial Doppler. RESULTS Risk of stroke occurrence increases with increasing degree of stenosis in carotid artery. It is estimated that the annual risk of stroke occurrence increased by less than 1% in patients with < 80% stenosis and 4.8% in patients with > 90% stenosis. Early intervention in patients with lesser degree of carotid artery stenosis will decrease the risk of future stroke. Transcranial Doppler and Carotid Doppler are the best non-invasive and widely available screening tool for carotid stenosis. But the disadvantage of transcranial Doppler is that it is operator inadequate temporal windows, especially in older individuals. Transcranial Doppler can be used as an initial imaging modality to exclude intracranial carotid artery stenosis. CONCLUSION Most of the patients with extracranial carotid artery disease also had coexisting intracranial carotid artery disease, which in turn may further lead to stroke. This emphasises the need to search for intracranial disease in patients with extracranial carotid artery disease. Transcranial Doppler can be used as non-invasive initial screening tool for detecting intracranial carotid artery stenosis before considering any invasive investigation.
Authors and Affiliations
Veni Alagamuthu, Ravi Kumar Veeramalai
Keywords
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- EP ID EP412102
- DOI 10.14260/jemds/2018/351
- Views 66
- Downloads 0
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