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Related Experiment Videos

Silent stroke and carotid stenosis.

J W Norris1, C Z Zhu

  • 1Stroke Research Unit, Sunnybrook Health Science Centre, University of Toronto, Canada.

Stroke
|April 1, 1992
PubMed
Summary

Silent cerebral infarction is linked to carotid artery narrowing. Increased severity of carotid stenosis correlates with a higher risk of ipsilateral cerebral infarction, suggesting endarterectomy may benefit asymptomatic patients.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Radiology

Background:

  • Silent cerebral infarction is frequently detected via computed tomographic (CT) scans in individuals with asymptomatic carotid stenosis.
  • The precise relationship between silent cerebral infarction and the degree of arterial stenosis remains unclear.

Purpose of the Study:

  • To investigate the association between the severity of carotid stenosis and the occurrence of silent cerebral infarction.
  • To determine if silent cerebral infarction in asymptomatic patients warrants consideration for carotid endarterectomy.

Main Methods:

  • A comparative study involving computed tomographic (CT) scans and carotid Doppler assessments.
  • Patient groups included asymptomatic carotid stenosis, transient ischemic attacks with carotid stenosis, and transient ischemic attacks without carotid stenosis.

Main Results:

  • Cerebral infarcts were most prevalent in patients experiencing transient ischemic attacks with carotid stenosis (47%).
  • The incidence of cerebral infarcts ipsilateral to carotid stenosis increased with stenosis severity: 10% (mild), 17% (moderate), and 30% (severe).
  • In asymptomatic patients, 68% of infarcts were ipsilateral to the stenosis.

Conclusions:

  • A direct correlation exists between the severity of carotid stenosis and the incidence of ipsilateral cerebral infarction.
  • Silent cerebral infarction, regardless of location (central or peripheral), may indicate a need for carotid endarterectomy in asymptomatic individuals.

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