Carotid stenosis is a major sequela of head and neck irradiation that has

Introduction: Stroke is the second leading cause of death globally, with more than 85% of deaths from stroke occurring in developing countries. It is also reported as the major sequel of head and neck irradiation and has not received the attention it deserves. The contribution of various risk factors to the burden of stroke worldwide is unknown, particularly in countries of low and middle income. We aimed to establish the association of known and emerging risk factors, the carotid intima–media thickness (IMT), with stroke in postradiotherapy patients with head and neck malignancies, also aimed to establish whether carotid IMT (cIMT) is an independent risk factor to predict future stroke. Material and Methods: The study recruited 501 subjects. 151 irradiated patients with head and neck malignancy, formed case group. Three hundred and fifty nonirradiated apparently healthy controls formed control group. Each group was subdivided into four subgroups on the basis of gender and presence or absence of classical atherogenic risk factors, i.e. totally 8 groups were structured. All subjects were measured for their cIMT by color Doppler, b-mode ultrasonography and were also made to complete a questionnaire to assess other cardiovascular risk factors. The Framingham score system was used to predict probability of stroke. Results: Study described higher values of cIMT and total points for risk factors in cases than in controls and the difference was again statistically significant (P = 0.0001). Discussion and Conclusion: CIMT clearly indicated to act as an independent risk factor to predict stroke and is suggested to be worked on to be incorporated in the Framingham score.

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Carotid stenosis is a major sequela of head and neck irradiation that has not received the attention it deserves. Its impact on the quality of life of patients can be substantial. This review discusses the incidence of radiation induced carotid stenosis and its role in prediction of stroke .Atherosclerotic changes of the common carotid artery(CCA) may appear like irregularities of the intima-media thickness (IMT) in B-mode ultrasound. Early detection can help to decrease or slow down the rate of prognosis of atherosclerosis and this can improve the quality, and increase the length of patient's life. The incidence of significant increase in carotid IMT following head and neck irradiation is seen. Patients with carotid stenosis are at increased risk for stroke. In this study,subjects with any other major risk factor for atherosclerosis were included. Subjects with previous history of cerebrovascular accidents were excluded.