Abstract TP205: Association Between Morphological Variations of Extracranial Internal Carotid Artery and Cerebral White Matter Hyperintensities

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yuying Yan ◽  
Bo Wu ◽  
Yirui Cao ◽  
Shuai Jiang ◽  
Jiayu Sun
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Blood Vessel ◽  
Internal Carotid Artery ◽  
White Matter Hyperintensities ◽  
Internal Carotid ◽  
Cerebral White Matter ◽  
Extracranial Internal Carotid Artery ◽  
Morphological Variations ◽  
History Of

Background: Cerebral white matter hyperintensities (WMHs) often remain asymptomatic until they widely affect brain structure. The association between small and large vessel diseases is worth studying. We aimed to explore the relationship between morphological variations of extracranial internal carotid artery (EICA) and WMHs. The classic evaluation system of artery variations failed to describe the compound abnormities, and therefore some novel parameters were proposed in this study. Methods: Neck CT angiography scans and brain MRI data of 97 patients with acute ischemic stroke were retrospectively analyzed. The angle of EICA, tortuosity index (TI), deviation degree (DD) and angular number (AN) were measured as parameters of artery morphological variations (Figure). The severity of WMHs was assessed by Fazekas Scale. Differences of vascular morphological variations between mild and severe white matter lesion groups and factors independently associated with WMHs were analyzed. Results: Compared with the patients with mild WMHs, patients with severe WMHs were older ( P =0.001), had higher average systolic blood pressure ( P =0.026), larger median TI ( P <0.001) and median DD ( P <0.001). Also, more patients with severe WMHs had sharp blood vessel angles ( P =0.001) and history of stroke ( P =0.034). Sharp blood vessel angle (OR 4.056, 95%CI 1.578-10.467) and TI (OR 1.037, 95%CI 1.007-1.068) were independently associated with severe WMHs proved by multivariate logistic analysis. Several regression models suggested that age and history of stroke had close relationship with WMHs. Conclusions: Sharp angle of EICA and TI were independently associated with severe WMHs. Besides, age and history of stroke were firmly related to white matter lesions.

scholarly journals Cerebrovascular disease progression in patients with ACTA2 Arg179 Pathogenic Variants

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011210
Author(s):  
Arne Lauer ◽  
Samantha L. Speroni ◽  
Jay B. Patel ◽  
Ellen Regalado ◽  
Myoung Choi ◽  
...  
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Disease Progression ◽  
White Matter Hyperintensities ◽  
Internal Carotid ◽  
White Matter Lesions ◽  
Critical Stenosis ◽  
Pathogenic Variants ◽  
Over Time

Objective:To establish progression of imaging biomarkers of stroke, arterial steno-occlusive disease and white matter injury in patients with smooth muscle dysfunction syndrome caused by mutations in the ACTA2 gene, we analyzed 113 cerebral MRI scans from a retrospective cohort of 27 patients with ACTA2 Arg179 pathogenic variants.Methods:Systematic quantifications of arterial ischemic strokes and white matter lesions were performed on baseline and follow-up scans using planimetric methods. Critical stenosis and arterial vessel diameters were quantified applying manual and semi-automated methods to cerebral MR angiograms. We then assessed correlations between arterial abnormalities and parenchymal injury.Results:We found characteristic patterns of acute white matter ischemic injury and progressive internal carotid artery stenosis during infancy. Longitudinal analysis of patients older than 1.2 years showed stable white matter hyperintensities but increased number of cystic-like lesions over time. Progressive narrowing of the terminal internal carotid artery occurred in 80% of patients and correlated with the number of critical stenosis in cerebral arteries and arterial ischemic infarctions. Arterial ischemic strokes occurred in same territories affected by critical stenosis.Conclusions:We found characteristic, early and progressive cerebrovascular abnormalities in patients with ACTA2 Arg179 pathogenic variants. Our longitudinal data suggests that while steno-occlusive disease progresses over time and is associated with arterial ischemic infarctions and cystic-like white matter lesions; white matter hyperintensities can remain stable over long periods. Above evaluated metrics will enable diagnosis in early infancy and be used to monitor disease progression, guide timing of stroke preventive interventions and assess response to current and future therapies.

Increased tortuosity of bilateral distal internal carotid artery is associated with white matter hyperintensities

2020 ◽  
pp. 028418512093238
Author(s):  
Jiyang Liu ◽  
Xiaoting Ke ◽  
Qingquan Lai
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
White Matter Hyperintensities ◽  
Internal Carotid ◽  
White Matter Hyperintensity ◽  
Intracranial Volume ◽  
Brain White Matter ◽  
Distal Internal Carotid Artery

Background Although the pathophysiology of white matter hyperintensities remains unclear, we can recently explore the possible relationship with white matter hyperintensities by using quantitative parameter. Purpose To demonstrate the relationship between bilateral distal internal carotid arterial tortuosity and total brain white matter hyperintensities volume in elderly individuals. Material and Methods A total of 345 patients (age > 65 years) with brain magnetic resonance (MR) examinations were retrospectively included (44.1% men; mean age = 72.1 ± 6.25 years; 55.9% ≥ 70 years). We measured the Tortuosity Index (TI) of the bilateral distal internal carotid artery and basilar artery on MR angiography imaging, and white matter hyperintensities volume on fluid-attenuated inversion recovery MR sequence. Multiple linear regression was used to assess the association of the TI with quantitatively derived brain white matter hyperintensity volume, after adjusting for demographics (age, sex), vascular risk factors (hypertension, diabetes, heart disease), and vessel diameters, total intracranial volume (TIV). Results Increased tortuosity of bilateral distal internal carotid artery was associated with greater burden of white matter hyperintensity volume (right: β = 11.223, P = 0.016; left: β = 20.701, P < 0.001). This relationship was independent of age and hypertension, both of which have been considered the strongest risk factors for white matter hyperintensities. Conclusion Our results suggest that tortuosity of the bilateral distal internal carotid artery is associated with white matter hyperintensities, independent of age and hypertension.

scholarly journals Blood Pressure, Internal Carotid Artery Flow Parameters, and Age-Related White Matter Hyperintensities

Hypertension ◽  
2014 ◽  
Vol 63 (5) ◽  
pp. 1011-1018 ◽  
Author(s):  
Benjamin S. Aribisala ◽  
Zoe Morris ◽  
Elizabeth Eadie ◽  
Avril Thomas ◽  
Alan Gow ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
White Matter Hyperintensities ◽  
Internal Carotid ◽  
Flow Parameters ◽  
Age Related ◽  
Artery Flow

Unruptured intracranial aneurysms in children: 18 years’ experience in a tertiary care pediatric institution

2019 ◽  
Vol 24 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Daniel-Alexandre Bisson ◽  
Peter Dirks ◽  
Afsaneh Amirabadi ◽  
Manohar M. Shroff ◽  
Timo Krings ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Tertiary Care ◽  
Unruptured Intracranial Aneurysms ◽  
History Of ◽  
Mean Size

OBJECTIVEThere are little data in the literature on the characteristics and natural history of unruptured intracranial aneurysms in children. The authors analyzed their experience with unruptured intracranial aneurysms in the pediatric population at their tertiary care pediatric institution over the last 18 years. The first objective was to assess the imaging characteristics and natural history of these aneurysms in order to help guide management strategies in the future. A second objective was to evaluate the frequency of an underlying condition when an incidental intracranial aneurysm was detected in a child.METHODSThe authors conducted a Research Ethics Board–approved retrospective review of incidental intracranial aneurysms in patients younger than 18 years of age who had been treated at their institution in the period from 1998 to 2016. Clinical (age, sex, syndrome) and radiological (aneurysm location, type, size, thrombus, mass effect) data were recorded. Follow-up imaging was assessed for temporal changes.RESULTSSixty intracranial aneurysms occurred in 51 patients (36 males, 15 females) with a mean age of 10.5 ± 0.5 years (range 9 months–17 years). Forty-five patients (88.2%) had a single aneurysm, while 2 and 3 aneurysms were found in 3 patients each (5.8%). Syndromic association was found in 22 patients (43.1%), most frequently sickle cell disease (10/22 [45.5%]). Aneurysms were saccular in 43 cases (71.7%; mean size 5.0 ± 5.7 mm) and fusiform in the remaining 17 (28.3%; mean size 6.5 ± 2.7 mm). Thirty-one aneurysms (51.7%) arose from the internal carotid artery (right/left 1.4), most commonly in the cavernous segment (10/31 [32.3%]). Mean size change over the entire follow-up of 109 patient-years was a decrease of 0.6 ± 4.2 mm (range −30.0 to +4.0 mm, rate −0.12 ± 9.9 mm/yr). Interval growth (2.0 ± 1.0 mm) was seen in 8 aneurysms (13.3%; 4 saccular, 4 fusiform). An interval decrease in size (8.3 ± 10.7 mm) was seen in 6 aneurysms (10%). There was an inverse relationship between aneurysm size and growth rate (r = −0.82, p < 0.00001). One aneurysm was treated endovascularly with internal carotid artery sacrifice.CONCLUSIONSUnruptured pediatric intracranial aneurysms are most frequently single but can occur in multiples in a syndromic setting. None of the cases from the study period showed clinical or imaging signs of rupture. Growth over time, although unusual and slow, can occur in a proportion of these patients, who should be identified for short-term imaging surveillance.

Extracranial internal carotid artery: anatomical variations in asymptomatic patients

2016 ◽  
Vol 38 (8) ◽  
pp. 893-902 ◽  
Author(s):  
Salvatore Cappabianca ◽  
Francesco Somma ◽  
Alberto Negro ◽  
Michele Rotondo ◽  
Assunta Scuotto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Anatomical Variations ◽  
Extracranial Internal Carotid Artery ◽  
Asymptomatic Patients
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