- 期刊
Correlation of Common Carotid Artery Intima Media Thickness, Intracranial Arterial Stenosis and Post-stroke Cognitive Impairment
並列摘要
Background and Purpose: Atherosclerosis of the intracranial arteries is a well-recognized cause of ischemic stroke in Asians, and extracranial carotid artery disease is more often seen in western countries. The relationship of common carotid artery intima-media thickness (CCA-IMT), intracranial arteries stenosis (ICS) and vascular cognitive impairment (VCI) after ischemic stroke has not been fully elucidated. In this study, we investigated the relationship between CCA-IMT and the severity of ICS and VCI. Methods: We recruited patients from December 2004, to June 2005, with the inclusion criteria: (1) first-ever ischemic stroke, (2) admission within 3 days of stroke onset, (3) under 80 years old, and (4) no previous dementia history. We excluded patients with stroke scores greater than an NIHSS of 15; those with recurrent stroke, and those with extracranial internal carotid artery stenosis＞50%. All the patients underwent brain MR angiography, carotid ultrasonography and neuropsychological testing during hospitalization and at 3 months after stroke. We defined the percent of ICS using the method of Warfarin-Aspirin Symptomatic Intracranial Disease. Measurement of CCA-IMT was made on the far wall of the common carotid artery, 1.5 cm proximal to the bifurcation at a point free of plaques. Cognitive performance was assessed using the Cognition Assessment State Instrument (CASI). Results: Thirty patients (21M/9F, mean age 65.97±10.33 years) were studied. The initial CCA-IMT was 1.04±0.59 mm and the initial CASI was 64.73±14.75. The ICS was 70±26%. At 3 months after stroke, the CCA-IMT was 1.06±0.59 mm; and CASI was 70.07±18.50. Compared with patients with CCA-IMT＞0.87 mm, those with CCA-IMT≤0.87 mm had lower ICS (57±23% vs. 81±24%, p=0.013), but similar initial CASI score (67.92±13.52 vs. 61.93±16.64, p=0.28). The improvement of CASI score at 3 months was significantly higher in patients with CCA-IMT≤0.87 mm (67.92±13.52 vs. 77.36±14.12, p=0.001), than those with CCA-IMT＞0.87 mm (61.93±16.64 vs. 63.69±19.89, p=0.612). Conclusions: CCA-IMT might be associated with the severity of ICS and VCI at 3 months after the first-ever ischemic stroke. The patients with lower CCA-IMT had a better CASI evaluation at 3 months after stroke. A larger scale of study to explore the association of CCA-IMT, VCI and ICS at 3 months after stroke might help farther delineation of these relationships.
延伸閱讀
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