Carotid Bulb Webs as a Cause of "Cryptogenic" Ischemic Stroke
Carotid Bulb Webs as a Cause of "Cryptogenic" Ischemic Stroke
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DOI：
10.3174/ajnr.a5208
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发表时间：
2017-07-01
影响因子：
3.5
通讯作者：
Raghavan, P.
中科院分区：
文献类型：
--
作者：
Sajedi, P. I.;Gonzalez, J. N.;Raghavan, P.
背景和目的：颈动脉网是颈动脉球部管腔内的架状充盈缺损，最近认识到其对复发性缺血性中风患者的影响。我们试图确定颈动脉网是否是隐源性缺血性中风的一个未被充分认识的原因，并估计其在一般人群中的患病率。 材料和方法：对过去 6 年中隐源性中风年轻患者 (n = 33) 的颈部 CTA 研究进行回顾性审查，以确定颈动脉网的患病率，与因缺血性中风以外原因接受颈部 CTA 研究的对照组患者 (n = 33) 进行比较。 63). 结果：隐源性中风人群中颈动脉网的患病率为 21.2%（95% CI，8.9%-38.9%）。有颈动脉蹼症状的患者平均年龄为 38.9 岁（范围为 30-48 岁），大多数为非裔美国人 (86%) 和女性 (86%)。相比之下，对照组中只有 1.6%（95% CI，0%-8.5%）的患者表现出网状结构。我们的研究结果表明，颈动脉网与缺血性中风之间存在统计学上显着的关联（OR = 16.7；95% CI，2.78-320.3；P = .01）。结论：颈动脉网与缺血性中风有很强的相关性，对于缺乏其他危险因素的患者，尤其是非裔美国女性，应怀疑颈动脉网的存在。
BACKGROUND AND PURPOSE: Carotid webs are intraluminal shelf-like filling defects at the carotid bulb with recently recognized implications in patients with recurrent ischemic stroke. We sought to determine whether carotid webs are an under-recognized cause of cryptogenic ischemic stroke and to estimate their prevalence in the general population.MATERIALS AND METHODS: A retrospective review of neck CTA studies in young patients with cryptogenic stroke over the past 6 years (n = 33) was performed to determine the prevalence of carotid webs compared with a control group of patients who received neck CTA studies for reasons other than ischemic stroke (n = 63).RESULTS: The prevalence of carotid webs in the cryptogenic stroke population was 21.2% (95% CI, 8.9%-38.9%). Patients with symptomatic carotid webs had a mean age of 38.9 years (range, 30-48 years) and were mostly African American (86%) and women (86%). In contrast, only 1.6% (95% CI, 0%-8.5%) of patients in the control group demonstrated a web. Our findings demonstrate a statistically significant association between carotid webs and ischemic stroke (OR = 16.7; 95% CI, 2.78-320.3; P = .01).CONCLUSIONS: Carotid webs exhibit a strong association with ischemic stroke, and their presence should be suspected in patients lacking other risk factors, particularly African American women.