Atherosclerotic Aortic Arch Plaques in Acute Ischemic Stroke

[摘要] Background: Atherosclerotic aortic arch plaques (AAP) have been linked to an increased risk of thromboembolic events as a cause of acute ischemic stroke of undetermined etiology. Objective: To find out the presence of atherosclerotic plaques in aortic arch and their potential role as a source of embolism in cerebral infarction of undetermined etiology. Methods: We performed transesophageal echocardiography (TEE) and multislice computerized tomography (MSCT) of the aortic arch on 30 patients with acute ischemic stroke of undetermined cause from a total series of 150 non-selected patients with acute ischemic stroke studied prospectively by clinical evaluation, laboratory investigations, cranial computed tomography; color coded duplex ultrasonography of the carotid arteries and transcranial Doppler (TCD). Results: Using transesophageal echocardiography eight patients (29.6%) had atherosclerotic aortic arch plaques, while using multislice computerized tomography atherosclerotic aortic arch plaques were revealed in twelve patients (40%). Atherosclerotic aortic arch plaques were significantly related to older age, male gender, hypertension, ischemic heart disease and low-grade atherosclerotic carotid lesions. Multislice computerized tomography of the aortic arch was more sensitive than transesophageal echocardiography in detecting the site, size and characters of atherosclerotic aortic arch plaques. Conclusion: Atherosclerotic aortic arch plaques are a frequent finding in patients with acute ischemic stroke of undetermined cause supporting the hypothesis that aortic plaques have embolic potential. In addition, multislice computerized tomography is more sensitive than transesophageal echocardiography in detecting atherosclerotic aortic arch plaques and better characterization of these plaques especially relevant one. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 163-168)

[学科分类] 精神健康和精神病学