Document Detail

Stroke radiology and distinguishing characteristics of intracranial atherosclerotic disease in native South Asian Pakistanis.
MedLine Citation:
PMID:  23013556     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There are no descriptions of stroke mechanisms from intracranial atherosclerotic disease in native South Asian Pakistanis.
METHODS: Men and women aged ≥ 18 years with acute stroke presenting to four tertiary care hospitals in Karachi, Pakistan were screened using magnetic resonance angiography/transcranial Doppler scans. Trial of ORG 10172 in Acute Stroke Treatment criteria were applied to identify strokes from intracranial atherosclerotic disease.
RESULTS: We studied 245 patients with acute stroke due to intracranial atherosclerotic disease. Two hundred thirty scans were reviewed. Also, 206/230 (89.0%) showed acute ischaemia. The most frequent presentation was with cortically based strokes in 42.2% (87/206) followed by border-zone infarcts (52/206, 25.2%). Increasing degrees of stenosis correlated with the development of both cortical and border-zone strokes (P = 0.002). Important associated findings were frequent atrophy (166/230, 72.2%), silent brain infarcts (66/230, 28%) and a marked lack of severe leukoaraiosis identified in only 68/230 (29.6%). A total of 1870 arteries were studied individually. Middle cerebral artery was the symptomatic stroke vessel in half, presenting with complete occlusion in 66%. Evidence of biological disease, symptomatic or asymptomatic was identified in 753 (40.2%) vessels of which 543 (72%) were significantly (>50%) stenosed at presentation.
CONCLUSION: Intracranial atherosclerotic disease is a diffuse process in Pakistani south Asians, with involvement of multiple vessels in addition to the symptomatic vessel. The middle cerebral artery is the most frequent symptomatic vessel presenting with cortical embolic infarcts. There is a relative lack of leukoaraiosis. Concomitant atrophy, silent brain infarcts and recent ischaemia in the symptomatic territory are all frequently associated findings.
Maria Khan; Asif Rasheed; Saman Hashmi; Moazzam Zaidi; Muhammad Murtaza; Saba Akhtar; Lajpat Bansari; Nabi Shah; Maria Samuel; Sadaf Raza; Umer Rais Khan; Bilal Ahmed; Bilawal Ahmed; Naveeduddin Ahmed; Jamal Ara; Tasnim Ahsan; S M Munir; Shoukat Ali; Khalid Mehmood; Karim Ullah Makki; Muhammad Masroor Ahmed; Niaz Sheikh; Abdul Rauf Memon; Philippe M Frossard; Ayeesha Kamran Kamal
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-09-27
Journal Detail:
Title:  International journal of stroke : official journal of the International Stroke Society     Volume:  8 Suppl A100     ISSN:  1747-4949     ISO Abbreviation:  Int J Stroke     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-23     Completed Date:  2014-05-27     Revised Date:  2014-10-15    
Medline Journal Info:
Nlm Unique ID:  101274068     Medline TA:  Int J Stroke     Country:  England    
Other Details:
Languages:  eng     Pagination:  14-20     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.
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MeSH Terms
Brain Ischemia / ethnology,  pathology*
Case-Control Studies
Intracranial Arteriosclerosis / ethnology,  pathology*
Magnetic Resonance Imaging
Middle Aged
Pakistan / ethnology
Stroke / ethnology,  pathology*
Tomography, X-Ray Computed
Young Adult
Grant Support

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