Related Experiment Video

Updated: May 14, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Diabetes, intracranial stenosis and microemboli in asymptomatic carotid stenosis

Thach D Lam1, Stephanie Lammers, Claudio Munoz

  • 1Schulich School of Medicine and Dentistry, Stroke Prevention and Atherosclerosis Research Centre, University of Western Ontario, London, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|February 20, 2013
PubMed

Insights

Patients with asymptomatic carotid stenosis face a higher stroke risk if they have microemboli or intracranial stenosis. Diabetes significantly increases these risks, suggesting a need for more intensive therapy in diabetic patients.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Medical Imaging

Background:

  • Asymptomatic carotid stenosis (ACS) poses a risk of stroke, necessitating methods to identify high-risk patients.
  • Current risk stratification for ACS needs refinement, especially for patients who may benefit from specific interventions or medical therapies.

Purpose of the Study:

  • To investigate the predictive value of intracranial arterial stenosis and microemboli detected by transcranial Doppler (TCD) for stroke, death, or transient ischemic attacks (TIA) in patients with ACS.
  • To assess the impact of diabetes mellitus on microemboli, intracranial stenosis, and the overall risk of cerebrovascular events.

Main Methods:

  • 339 patients with ACS (>60% stenosis) were recruited and underwent TCD for intracranial stenosis and microemboli detection, alongside carotid ultrasound.
  • Participants were followed for three years to record the incidence of stroke, death, or TIA.
  • The study analyzed the association between microemboli, intracranial stenosis, diabetes, and the risk of adverse cerebrovascular events.

Main Results:

  • Patients with microemboli had a significantly higher risk of stroke/death/TIA (38% vs. 10%, p=0.0001).
  • Intracranial stenosis was also associated with increased risk (18% vs. 10%, p=0.042).
  • Diabetics showed higher rates of intracranial stenosis (45% vs. 29%), microemboli (38% vs. 10%), and a greater risk of stroke/death/TIA (21% vs. 11%).

Conclusions:

  • Diabetes, microemboli, and intracranial stenosis are significant predictors of higher stroke/death/TIA risk in ACS patients.
  • These factors are more predictive than extracranial stenosis or plaque area.
  • Diabetic patients with ACS may require more intensive management strategies to mitigate their elevated risk.
Abstract

More Related Videos

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability09:11

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability

Published on: February 23, 2016

Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
Arteries of the Head and Neck01:26

Arteries of the Head and Neck

The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...