Abstract
Cerebrovascular adverse events are one of the most common causes for morbidity and mortality worldwide. Thromboembolism being the culprit behind a significant number of such events. An attempt has been made to ascertain the association of carotid plaque morphology in the occurrence of ischemic stroke. Heterogeneous plaques (Type 2 & 3) weremostly observed to be ipsilateral to the side of brain infarct, as compared to the contralateral side. Detection of heterogeneous plaques and plaque ulceration in patients may indicate future development of stroke. This study included 75 consecutive patients having anterior circulation infarct in MRI of the brain and atherosclerotic changes in extra cranial carotid system on Carotid Duplex scan. Plaque morphology ipsilateral to the brain infarct was compared to that on the contralateral side. Significantly higher number of heterogeneous plaques (Type 2 & 3) were present ipsilateral to the side of brain infarct, as compared to the contralateral side (p-value 0.004). Plaque ulceration was also observed to be present more frequently on the side of infarct (22.6% on the ipsilateral side and 5.4% on the contralateral side). Moreover, Diabetes mellitus and dyslipidemia were the most prevalent risk factors (78.2% and 65.2%, respectively) in patients with these types of plaques. Detection of heterogeneous plaques and plaque ulceration in patients may indicate future development of stroke, necessitating prompt and appropriate management protocols.Periodic screening of such patients with Carotid Duplex Ultrasonography is expected to be very helpful.
Highlights
Stroke is defined as a sudden onset of focal neurologic deficit due to vascular cause. 1 It is one of the leading causes of mortality in India and accounting for about 11.8% of total deaths worldwide. 2,3 An Indian study observed that almost 70% of stroke related death was from the primary stroke and about 19.27% from a recurrent event
The present study found that heterogeneous plaques (Type 2 & 3) are more prevalent on the side of brain ischemic stroke compared to the opposite side (Table 1, Figure 5) and a statistically significant correlation existed in this regard (p-value 0.004)
Carotid plaque morphology is an important determinant for the occurrence of ischemic brain stroke
Summary
Stroke is defined as a sudden onset of focal neurologic deficit due to vascular cause. 1 It is one of the leading causes of mortality in India and accounting for about 11.8% of total deaths worldwide. 2,3 An Indian study observed that almost 70% of stroke related death was from the primary stroke and about 19.27% from a recurrent event. 2,3 An Indian study observed that almost 70% of stroke related death was from the primary stroke and about 19.27% from a recurrent event. This indicates that secondary preventive measures are more in effect than primary prevention in our country. Heterogeneous plaques (Type 2 & 3) weremostly observed to be ipsilateral to the side of brain infarct, as compared to the contralateral side. Result: Significantly higher number of heterogeneous plaques (Type 2 & 3) were present ipsilateral to the side of brain infarct, as compared to the contralateral side (p-value 0.004). Conclusion: Detection of heterogeneous plaques and plaque ulceration in patients may indicate future development of stroke, necessitating prompt and appropriate management protocols.Periodic screening of such patients with Carotid Duplex Ultrasonography is expected to be very helpful
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