Etiologic Mechanisms in Cerebral Atherosclerosis

Resch, Joseph A.

doi:10.1001/archneur.1964.00460180083008

Cited by 63 publications

(29 citation statements)

References 21 publications

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“…[6][7][8][9][10] Because intracranial stenosis usually represents an atherosclerotic lesion, it is not surprising that there is a clear correlation between intracranial stenosis and vascular diseases and vascular risk factors. [11][12][13][14][15] The aim of the present study was to search for possible determinants of potentially symptomatic middle cerebral artery stenosis in patients with stroke and transient ischemic attack in a biethnic (Jewish and Arab) population of northern Israel.…”

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confidence: 99%

Middle Cerebral Artery Stenosis in Patients with Acute Ischemic Stroke and TIA in Israel

Telman

Hurani

Sprecher

et al. 2014

American Journal of Neuroradiology

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confidence: 99%

Middle Cerebral Artery Stenosis in Patients with Acute Ischemic Stroke and TIA in Israel

Telman

Hurani

Sprecher

et al. 2014

American Journal of Neuroradiology

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“…2 Moreover, data from early autopsy series indicated that cerebral atherosclerosis (both intracranial and extracranial) was more prevalent and more severe in men, particularly between the ages of 40 and 60. 10,11 An additional autopsy study showed that the degree of endothelial surface involvement by raised intracranial atherosclerotic lesions was greater in men at nearly every age. 12 Compounding the limited data on gender differences in the prevalence and severity of intracranial stenosis is the paucity of data on gender differences in clinical outcomes among patients with this disease.…”

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confidence: 99%

Gender Differences in Outcomes Among Patients With Symptomatic Intracranial Arterial Stenosis

Williams

Chimowitz

Cotsonis

et al. 2007

Stroke

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for the WASID InvestigatorsBackground and Purpose-There are limited and conflicting data on gender differences in clinical outcomes among patients with symptomatic intracranial arterial stenosis. This study examined gender differences in patients enrolled in the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study. Methods-Participants were 569 men and women with symptomatic intracranial arterial stenosis. They were followed-up for the occurrence of ischemic stroke and the combined end point of stroke or vascular death from February 1999 through July 2003 (mean follow-up, 1.8 years). Results-Two-year rates of the primary end point were 28.4% and 16.6% for women and men, respectively. Cumulative probabilities of the outcomes over time were estimated by the Kaplan-Meier product-limit method and were compared between men and women with the use of the log-rank test. Cox proportional hazards regression analyses were used to estimate the hazard ratio of gender (women to men) for ischemic stroke and for the primary end point. The probabilities of ischemic stroke (Pϭ0.005) and of the combined end point of stroke or vascular death (Pϭ0.017) over time were significantly higher in women than men. Women had a greater multivariate-adjusted risk for ischemic stroke (HR, 1.85; 95% CI, 1.14 to 3.01; Pϭ0.013) and for the combined end point of stroke or vascular death (HR, 1.58; 95% CI, 1.01 to 2.48; Pϭ0.045). Conclusions-Women with symptomatic intracranial arterial stenosis are at significantly greater risk for ischemic stroke and for the combined end point of stroke or vascular death. These findings suggest the need for vigorous screening of risk factors and for aggressive management of risk factors and stroke in women. They also suggest the need to ensure adequate numbers of women in clinical trials designed to explore new and promising therapies for intracranial arterial stenosis.

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“…Além disso, foi mais comum no sexo masculino, embora tenha havido aumento considerável da frequência da aterosclerose nas mulheres com o avançar da idade, e sua frequência e gravidade aumentaram igualmente com a idade. Em uma grande série de 1739 pacientes com mais de 61 anos de idade, Resch & Baker 29 não encontraram diferenças apreciáveis na frequência da aterosclerose cerebral entre os dois sexos. Entretanto, Resch et al 30 e Flora et al 31 , numa série muito maior, observaram aumento da frequência e da gravidade da aterosclerose cerebral nas mulheres a partir da oitava dé-cada.…”

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“…Entretanto, Resch et al 30 e Flora et al 31 , numa série muito maior, observaram aumento da frequência e da gravidade da aterosclerose cerebral nas mulheres a partir da oitava dé-cada. A graduação macroscópica da aterosclerose cerebral, utilizada no presente trabalho, embora sujeita a alguma imprecisão 32 e certamente menos exata do que o sistema proposto por outros auto-res 11,29 , baseou-se em critérios definidos e semi-quantitativos e foi empregada pelo mesmo observador, tornando-a reproduzível. Resch 23,30,[33][34][35][36][37] , as quais em parte dependem do fato de que muitos dos fatores de risco da aterosclerose são determinados pelos hábitos de vida e condições sócio-econô-micas 1 .…”

Section: Discussionunclassified

“…A maior frequência e gravidade da aterosclerose cerebral nos norte-americanos em relação aos achados da presente série podem ser talvez explicadas por diferenças ambientais, particularmente por fatores dietéticos. A aterosclerose cerebral afeta mais intensamente as artérias carótidas internas, cerebrais médias, basilar, cerebrais posteriores e vertebrais 23,29,38 e essas localizações foram as mais frequentemente encontradas na presente série. Apesar das artérias do sistema carotidiano e vertebral em seu trajeto extracraniano não terem sido examinadas, sabe-se que esses vasos são comumente atingidos pela aterosclerose 38 .…”

Section: Discussionunclassified

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Prevalência e padrão de distribuição das doenças cerebrovasculares em 242 idosos, procedentes de um hospital geral, necropsiados em Belo Horizonte, Minas Gerais, no período de 1976 a 1997

Pittella

Duarte

2002

Arq. Neuro-Psiquiatr.

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RESUMO -Objetivo: Descrever a prevalência e os tipos das doenças cerebrovasculares (DCVs) em indivíduos idosos necropsiados. Método: Foram consultados os laudos neuropatológicos de 242 pacientes com idade igual ou superior a 61 anos, procedentes em sua maioria do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte, Minas Gerais, e necropsiados consecutivamente no período 1976 a 1997. Resultados: Os principais grupos de doenças do sistema nervoso central (SNC) foram representados por DCVs (71,9%), infecções (12,4%), neoplasias (7,1%), traumatismos crânio-encefálicos (3,7%), doenças nutricionais (2,5%) e doenças degenerativas (1,7%). As DCVs mais frequentes foram: aterosclerose (61,2%), doença cerebrovascular hipertensiva (25,6%) e infarto cerebral (14,9%). Observou-se aumento da frequência e da gravidade da aterosclerose e da frequência da doença cerebrovascular hipertensiva com o avançar da idade. Houve associação significativa entre doença cerebrovascular hipertensiva e aterosclerose. As DCVs foram clinicamente sintomáticas e as responsáveis diretas pelo óbito em 42,7% e 17,3% dos pacientes, respectivamente. Conclusão: As DCVs constituíram o principal grupo de doenças do SNC no idoso. A aterosclerose e a doença cerebrovascular hipertensiva foram as principais doenças deste grupo, notando-se aumento de sua frequência com o avançar da idade e associação significativa entre ambas. The prevalent diseases of the central nervous system (CNS) found in decreasing order were: CVDs (71.9%), infections (12.4%), neoplasms (7.1%), head trauma (3.7%), nutritional diseases (2.5%) and degenerative diseases (1.7%). The most common CVDs were cerebral atherosclerosis (61.2%), hypertensive cerebrovascular disease (25.6%) and cerebral infarct (14.9%). There was an increase in prevalence and severity of atherosclerosis and an increase in prevalence of hypertensive cerebrovascular disease with advancing age. A significant association between hypertensive cerebrovascular disease and atherosclerosis was found. The CVDs patients had clinical stroke and this was the direct cause of death in 42,7% and 17,3% of the cases, respectively. Conclusion: The CVDs were the most prevalent group of diseases of the CNS in elderly patients. Atherosclerosis and hypertensive cerebrovascular disease were the most common CVDs, and its prevalence increased with advancing age. Hypertensive cerebrovascular disease was significantly associated with atherosclerosis.

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Etiologic Mechanisms in Cerebral Atherosclerosis

Cited by 63 publications

References 21 publications

Middle Cerebral Artery Stenosis in Patients with Acute Ischemic Stroke and TIA in Israel

Middle Cerebral Artery Stenosis in Patients with Acute Ischemic Stroke and TIA in Israel

Gender Differences in Outcomes Among Patients With Symptomatic Intracranial Arterial Stenosis

Prevalência e padrão de distribuição das doenças cerebrovasculares em 242 idosos, procedentes de um hospital geral, necropsiados em Belo Horizonte, Minas Gerais, no período de 1976 a 1997

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