Asymptomatic middle cerebral artery stenosis diagnosed by magnetic resonance angiography
O O Zaidat1, D B Zahuranec, E E Ubogu
1Department of Neurology, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Ohio, USA. ozaidat@hotmail.com
Abstract:
We reviewed 1440 MRA studies to identify patients with middle cerebral artery stenosis (MCAS). We identified 99 cases, and after reviewing the clinical records, classified 28 as asymptomatic MCAS (AMCAS), a prevalence of 2%. Suspected stroke was the most frequent indication for MRA. Follow-up was available for 21, mean 46.7 months (range 2.4-75.6 months). One stroke occurred in the AMCAS territory (5%), other strokes in five patients (24%). There were five deaths in patients with MCAS; age > 69 (P = 0.045) was the only associated risk factor. This study suggests that patients in whom MRA is performed and shows AMCAS may be at increased risk of strokes in any vascular distribution or of death.
Insights
Asymptomatic middle cerebral artery stenosis (AMCAS) found in 2% of MRA studies indicates a higher risk of stroke or death. Advanced age is a significant risk factor for mortality in these patients.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Middle cerebral artery stenosis (MCAS) is a significant cerebrovascular condition.
- Magnetic Resonance Angiography (MRA) is a key imaging modality for diagnosing MCAS.
- Understanding the clinical significance of asymptomatic MCAS is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of asymptomatic middle cerebral artery stenosis (AMCAS).
- To evaluate the risk of stroke and mortality in patients diagnosed with AMCAS.
- To identify risk factors associated with adverse outcomes in patients with MCAS.
Main Methods:
- Retrospective review of 1440 MRA studies.
- Identification and classification of 99 MCAS cases, with 28 classified as AMCAS.
- Clinical record review and follow-up data collection for a subset of patients.
Main Results:
- The prevalence of AMCAS was identified as 2% (28 out of 99 cases).
- One stroke occurred in the AMCAS territory (5%), while five other strokes occurred in patients with MCAS (24%).
- Age greater than 69 was the only significant risk factor for mortality (P = 0.045) among MCAS patients.
Conclusions:
- Patients with MRA-detected AMCAS may face an elevated risk of stroke across any vascular territory.
- AMCAS diagnosis is associated with an increased risk of mortality.
- Age > 69 is a critical factor predicting mortality in patients with MCAS.
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