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Is there a side predilection for cerebrovascular disease?
Sergio A Rodríguez Hernández1, Abraham A Kroon, Martin P J van Boxtel
1Department of Internal Medicine, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht, The Netherlands.
Hypertension (Dallas, Tex. : 1979)
|June 18, 2003
Summary
Cerebrovascular disease may favor the left side. Studies show left carotid artery intima-media thickness is greater, correlating with more left-sided strokes, suggesting increased hemodynamic stress.
Area of Science:
- Vascular biology and neurology
- Cardiovascular research
- Stroke epidemiology
Background:
- Cerebrovascular disease research often assumes symmetrical distribution of abnormalities.
- Intima-media thickness (IMT) is a key marker for atherosclerosis and stroke risk.
- Hypertension is a major risk factor for cerebrovascular disease.
Purpose of the Study:
- To investigate potential asymmetry in common carotid artery intima-media thickness (CCA-IMT) between left and right sides.
- To determine if cerebrovascular accident (CVA) incidence shows a side preference.
- To explore the relationship between carotid IMT asymmetry and stroke laterality.
Main Methods:
- B-mode ultrasonography was used to measure left and right CCA-IMT in 102 untreated hypertensive patients.
- Cross-sectional area and flow velocity of the carotid arteries were analyzed.
- A population-based Stroke Registry of 1843 subjects was reviewed for stroke incidence and location.
Main Results:
- A statistically significant difference in CCA-IMT was found, with the left side exhibiting greater thickness (0.75+/-0.11 mm) than the right (0.71+/-0.11 mm; P<0.001).
- Higher cross-sectional intima-media area and flow velocity were observed on the left side, but arterial diameters were similar.
- The Stroke Registry revealed a significantly higher incidence of nonlacunar CVAs on the left side, while lacunar infarcts were symmetrically distributed.
Conclusions:
- Findings suggest a predilection for cerebrovascular disease on the left side.
- This asymmetry may be linked to increased hemodynamic stress and subsequent intimal damage in the left carotid artery.
- The results challenge the assumption of symmetrical distribution in cerebrovascular abnormalities and highlight potential lateralization in stroke risk factors.