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Carotid hemodynamic parameters are useful for discriminating between atherothrombotic infarction and lacunar infarction.
MedLine Citation:
PMID:  20619678     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Using ultrasound, we investigated whether carotid parameters differed among subtypes of ischemic stroke and evaluated the usefulness of these parameters in discriminating among subtypes. Patients with ischemic stroke admitted to Nippon Medical School Hospital were consecutively recruited and grouped into 3 subtypes based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification: cardioembolism (group CE), large-artery atherosclerosis (group LAA), and small-vessel occlusion (group SVO). All subjects underwent carotid ultrasonography to determine maximum intima-media thickness (IMT), maximum systolic velocity (Vmax), minimum diastolic velocity (Vmin), mean velocity, and pulsatility index (PI). Carotid parameters that differed among subtypes were statistically identified. A total of 138 patients were enrolled. Intergroup comparisons revealed that the Vmin of the affected side was significantly lower in group LAA than in group SVO (mean±SD, 0.12±0.05 m/s vs 0.15±0.05 m/s; P=.02) and the Vmin of the mean of both sides was lower in group LAA than in group SVO (0.12±0.04 vs 0.16±0.05; P=.03). Multivariate analysis showed that the PI of the affected side was a useful adjunct to discriminate between groups SVO and LAA (odds ratio=2.94; P=.03, group SVO as control). Receiver operating characteristic curve analysis found that the Vmin of the affected side was the most useful parameter for discriminating between group SVO and group LAA. The PI and the Vmin of the affected side were found to differ among stroke subtypes, and thus these may be useful parameters for discriminating among ischemic stroke subtypes.
Authors:
Yutaka Nishiyama; Toshiya Katsumata; Tatsuo Otori; Yasuo Katayama
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Publication Detail:
Type:  Journal Article     Date:  2010-07-08
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  19     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-11-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Internal Medicine, Division of Neurology, Nephrology, and Rheumatology, Nippon Medical School, Tokyo, Japan. yutakanms@yahoo.co.jp
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