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[Carotid stenosis and lacunar infarct]
J Tejada1, E Díez-Tejedor, L Hernández
1Sección de Neurología, Hospital de León, España.
Revista De Neurologia
|October 21, 1999
Summary
Carotid stenosis (CS) is a significant risk factor for lacunar infarcts (LI), particularly when isolated and on the same side as the ischemia. This finding is crucial for understanding stroke causes.
Area of Science:
- Neurology
- Vascular Medicine
- Stroke Research
Background:
- Perforating artery disease is the primary cause of lacunar infarcts (LI).
- The association between carotid stenosis (CS) and LI remains controversial in medical literature.
Purpose of the Study:
- To investigate the relationship between carotid stenosis (CS) and lacunar infarcts (LI).
- To differentiate the association in isolated versus multiple lacunar infarcts within the carotid territory.
Main Methods:
- Prospective study of 330 patients with a first cerebral infarct in the carotid artery territory.
- Classification of infarcts into 205 lacunar infarcts (LI) and 125 non-lacunar infarcts (NLI).
- Assessment of vascular risk factors and carotid stenosis using duplex-colour ultrasound.
Main Results:
- Isolated LI showed a 22% ipsilateral and 8% contralateral CS (>50%).
- Significant CS (>70%) was observed in 14% ipsilateral and 8% contralateral arteries.
- CS >50-70% was significantly higher in NLI patients compared to LI patients for both arteries.
Conclusions:
- Carotid stenosis (CS) should be recognized as a contributing risk factor for lacunar infarcts (LI).
- Ipsilateral CS (>70%) is significantly associated with multiple lacunar infarcts presenting unilaterally.