Little Association between Intracranial Arterial Stenosis and Lacunar Stroke
Open Access
- 28 October 2010
- journal article
- research article
- Published by S. Karger AG in Cerebrovascular Diseases
- Vol. 31 (1), 12-18
- https://doi.org/10.1159/000319773
Abstract
Atheromatous middle cerebral artery (MCA) stenosis could cause lacunar stroke by occluding lenticulostriate artery origins, but atheroma is common, and previous studies lacked suitable controls. We aimed to determine if intracranial atheroma was more common in lacunar than in cortical ischaemic stroke. We recruited patients with lacunar stroke and controls with mild cortical stroke, confirmed the stroke subtype with magnetic resonance imaging and used transcranial Doppler ultrasound imaging to record flow velocity and focal stenoses in the basal intracranial arteries 1 month after stroke. We compared ipsi- and contralateral MCA mean flow velocities between stroke subtypes and tested for associations using linear mixed models. Amongst 67 lacunar and 67 mild cortical strokes, mean age 64 and 67 years, respectively, we found no difference in MCA mean flow velocity between cortical and lacunar patients. Increasing age and white matter lesion scores were independently associated with lower MCA flow velocities (0.2 cms–1 fall in velocity per year increase in age, p = 0.045; 3.75 cms–1 fall in flow velocity per point increase in white matter lesion score, p = 0.004). We found no intracranial arterial stenoses. MCA atheromatous stenosis is unlikely to be a common cause of lacunar stroke in white populations. Falling velocities with increasing white matter lesion scores may reflect progressive brain tissue loss leaving less tissue to supply.Keywords
This publication has 32 references indexed in Scilit:
- Differing Risk Factor Profiles of Ischemic Stroke SubtypesStroke, 2010
- Autopsy Prevalence of Intracranial Atherosclerosis in Patients With Fatal StrokeStroke, 2008
- Transcranial Doppler Hemodynamic Parameters and Risk of StrokeStroke, 2007
- Are Lacunar Strokes Really Different?Stroke, 2005
- Long-Term Mortality and Recurrent Stroke Risk Among Chinese Stroke Patients With Predominant Intracranial AtherosclerosisStroke, 2003
- Is Breakdown of the Blood-Brain Barrier Responsible for Lacunar Stroke, Leukoaraiosis, and Dementia?Stroke, 2003
- Association Between Arterial Stiffness and AtherosclerosisStroke, 2001
- The Quest for Early Predictors of Stroke EvolutionStroke, 2000
- Cerebral Infarcts Related to Isolated Middle Cerebral Artery StenosisStroke, 1997
- Comparison of cerebral angiography and transcranial Doppler sonography in acute stroke.Stroke, 1989