Journal
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
Volume 27, Issue 7, Pages 1956-1959Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jstrokecerebrovasdis.2018.02.042
Keywords
Cryptogenic stroke; carotid atherosclerosis; magnetic resonance imaging; carotid stenosis; carotid plaque; embolic stroke
Categories
Funding
- CIHR [120988]
- RSNA RE Awards [RR1561, RR1237]
- Canadian Stroke Network
- Heart and Stroke Foundation
- Tory Family
- Bastable Potts Chair
- Department of Medicine at Sunnybrook Health Sciences Centre
- Department of Medicine at University of Toronto
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Background: Many embolic strokes are of undetermined source (ESUS). Carotid artery intraplaque hemorrhage (IPH), an unstable component of atherosclerosis, may be an under-recognized etiology in patients with ESUS. We investigated the prevalence of carotid IPH detected noninvasively by magnetic resonance imaging (MRI). Methods: This pilot study analyzed data from a prospective cohort of patients with a recent ESUS who underwent MRI for carotid IPH assessment. All patients had carotid artery stenosis of less than 50%. The primary outcome was the presence of carotid IPH ipsilateral to the cerebral ischemic event. Results: The cohort comprised 35 consecutive patients with a recent carotid-territory ESUS who underwent carotid MRI (mean age 743 +/- 9.6 years). We found ipsilateral and contralateral IPH in 7 of 35 patients (20.0%) and in 3 of 35 patients (8.6%), respectively (P = .005). Conclusions: In this sample of patients with ESUS, 1 in 5 had carotid IPH ipsilateral to their acute infarct, as detected by MRI of the vessel wall. Further studies are warranted to investigate carotid IPH as an etiology of ESUS.
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