Identification of stroke-prone patients by panoramic and cervical spine radiography.

Abstract

To determine if calcified atherosclerotic lesions in the region of the bifurcation of the common carotid artery (a major cause of stroke) can be identified by conventional panoramic dental radiography. All those aged 65 years or older, of 500 consecutive out-patients enrolled in the dental clinic for comprehensive treatment and for whom it was possible to obtain a technically satisfactory panoramic radiograph, were included. The radiographs were evaluated for the presence of radiopacities within the soft tissues of the neck at the level of the lower margin of the third cervical vertebra. An antero-posterior cervical spine radiograph was obtained of those individuals with any such calcifications. Medical histories were obtained from patients with suspected lesions in order to determine the presence of risk factors known to be associated with stroke. Six individuals (4.5% of the final study population) had radiopacities which were confirmed by radiographs of the cervical spine to be calcified atheromas. The medical histories revealed risk factors associated with stroke. Panoramic radiographs obtained during the course of routine dental treatment may demonstrate calcified carotid atheromas in patients at risk of stroke.