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[Cerebrovascular diseases due to extra- and intracranial atherosclerosis]
M Kameyama1, F Udaka, H Sawada
1Sumitomo Hospital.
Insights
Atherosclerosis in Japan
Area of Science:
- Cardiovascular Science
- Neurology
- Radiology
Context:
- Extracranial artery atherosclerosis is prevalent in Japan.
- Current devices for cerebrovascular disease are numerous.
- Simple diagnostic signs like carotid bruit and aortic calcification offer valuable insights.
Purpose:
- To highlight the significance of simple diagnostic signs for extracranial and intracranial atherosclerosis.
- To discuss anti-heat-shock protein 64 antibody as a risk factor.
- To explore clinical variability and PET findings in carotid disease.
Summary:
- Auscultation of carotid bruit and aortic arch calcification on X-ray are valuable indicators of extracranial and intracranial atherosclerosis.
- Anti-heat-shock protein 64 antibody is identified as an independent risk factor for carotid atherosclerosis.
- Clinical presentations of carotid occlusion/stenosis vary, with PET revealing "misery perfusion" in watershed zones; regression is possible.
Impact:
- Enhances understanding of atherosclerosis detection.
- Identifies a novel risk factor for carotid disease.
- Improves diagnostic approaches and highlights potential for regression.
Abstract:
(1) In Japan, atherosclerosis in the extracranial arteries has now been more or less prevailing. (2) Many devices are widely used to extra- and intracranial vascular disease. However, such a simple sign as an auscultation of the carotid bruit or aortic-arch calcification in the X-ray picture may give valuable information of extra- and intracranial atherosclerosis. (3) Anti-heat-shock protein 64 antibody has recently been presented as an independent risk factor of carotid atherosclerosis. (4) Clinical features of carotid occlusion or stenosis are markedly variable. PET study has revealed that a water-shed ischemic zone may be in a state of "misery perfusion". (5) Regression may occur in the cervical as well as cerebral atherosclerosis.