Risk Factors and Stroke Mechanisms in Atherosclerotic Stroke

Abstract

Previous studies have addressed the differences in risk factors and stroke mechanisms between ICAS and ECAS, 2,3 but the results are inconsistent. Whereas some reported that hypertension, diabetes mellitus, and metabolic syndrome (MetS) are more closely associated with ICAS, 4-8 this was not confirmed by others. 9-11 It also remains unclear whether the risk factors and stroke mechanisms differ between anterior and posterior circulation atherosclerosis. 12Previous studies examined a small number of patients at single hospitals. 6,7,11 Most importantly, prospective studies that used detailed examinations, including advanced brain and vascular imaging, are scarce. The purpose of this study was to elucidate the differences in the risk factors and mechanisms of stroke between ICAS and ECAS, and between anterior and posterior circulation atherosclerosis. We developed a Background and Purpose-The aim of this study was to investigate differences in risk factors and stroke mechanisms between intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS) and between anterior and posterior circulation atherosclerosis. Methods-A multicenter, prospective, Web-based registry was performed on atherosclerotic strokes using diffusionweighted magnetic resonance imaging and magnetic resonance angiography. Stroke mechanisms were categorized as artery-to-artery embolism, in situ thrombo-occlusion, local branch occlusion, or hemodynamic impairment. Results-One-thousand patients were enrolled from 9 university hospitals. Age (odds ratio [OR]

Isolated MCA Disease in Patients Without Significant Atherosclerotic Risk Factors

“…23,24 Considering the high prevalence of HR-Dissection has been found to be another common finding in our cohort. Cervicocerebral artery dissection accounts for 1% to 2% of all ischemic strokes 25 and is one of the major causes of stroke in young patients.…”

Characteristics of paramedian pontine arteries disease and its association with hemoglobinA1c

“…Previous neuropathological studies demonstrated that a high incidence of subcortical infarctions in patients with DM, especially in the pons perfused by PPA (Baumgartner et al., 2003; Terai et al, 2000). A recent study showed that branch occlusion was a more important mechanism in posterior circulation diseases (Kim et al., 2012). Based on these reports, this study indicated that PPD is independently associated with HbA1c, compared with LD, which represented the control of diabetes.…”

“…The PPA are 200–300μ min diameter and have less variation (Aronson, 1973). In the presence of parental atherosclerotic thrombosis, the smaller and shorter perforating vessels may be more susceptible to occlusion (Kim et al., 2012; Peress, Kane, & Aronson, 1973). Future researches are expected to explain the exact mechanism of the correlation with PPD and HbA1c.…”

Internal Carotid Artery Stenting for Intracranial Atherosclerosis

“…Certainly specific ethnic groups such as individuals of African, Hispanic, and Asian decent are genetically predisposed. 12 Lifestyle factors such as diet, exercise, and smoking play an important role, as do medical conditions such as hyperlipidemia, hypertension, and diabetes. Intraluminal narrowing of major intracranial vessels such as the internal carotid and basilar arteries-as well as secondary branches such as the anterior, middle, and posterior cerebral arteries-can place the patient in a state of cerebral hypoperfusion.…”