Document Detail


Is a fetal origin of the posterior cerebral artery a risk factor for TIA or ischemic stroke? A study with 16-multidetector-row CT angiography.
MedLine Citation:
PMID:  18274809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Fetal origin of the posterior cerebral artery (PCA) is not uncommon. Whether patients with this anomaly have a higher risk of ischemic stroke in the territory of the PCA is not known. The clinical benefit of screening for a fetal origin in patients with TIA or stroke in the territory of the PCA and an ipsilateral atherosclerotic carotid stenosis is not clear. This study assessed the frequency of a fetal origin of the PCA in patients with a TIA or infarct in the territory of the PCA with 16-multidetector-row CT angiography (CTA). METHODS: 82 patients (52 male; mean age = 64; range 19 to 90 years) with isolated homonymous hemianopia and/or a PCA infarct underwent CTA of the carotid artery and circle of Willis. RESULTS: A fetal origin of the PCA at the symptomatic side was present in 14 patients (17 %) and at the asymptomatic side in 18 patients (22%) (OR: 0.7; 95 % CI: 0.3 to 1.7). Severity of stenosis (NASCET criteria) of the ICA at the symptomatic side was < 30%, 30-49% and > or = 50% in 72, 2 and 8 patients, respectively. Number and frequency of a fetal origin in these groups were 12 (17 %), 0 (0%) and 2 (25 %), respectively. There was no association between a severe carotid stenosis and a fetal origin of the PCA at the symptomatic side. CONCLUSION: This study does not provide arguments for an increased risk of ischemic stroke in the territory of the PCA in patients with a fetal origin of the PCA. A few patients with a TIA or infarct in the territory of the PCA have a fetal origin of the PCA in combination with a high-grade stenosis of the ipsilateral ICA, but not more often than one would expect from chance. Nevertheless, these patients may benefit from carotid endarterectomy.
Authors:
Cécile de Monyé; Diederik W J Dippel; Theodora A M Siepman; Marcel L Dijkshoorn; Hervé L J Tanghe; Aad van der Lugt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-18
Journal Detail:
Title:  Journal of neurology     Volume:  255     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  239-45     Citation Subset:  IM    
Affiliation:
Department of Radiology, Erasmus MC, University Medical Center, 's Gravendijkwal 230, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atherosclerosis / etiology
Brain Ischemia / complications*,  epidemiology*,  pathology
Cerebral Angiography
Data Interpretation, Statistical
Female
Humans
Image Processing, Computer-Assisted
Infarction, Posterior Cerebral Artery / pathology
Ischemic Attack, Transient / complications*,  epidemiology*,  radiography
Male
Middle Aged
Posterior Cerebral Artery / abnormalities*,  radiography
Retrospective Studies
Risk Factors
Stroke / epidemiology*,  etiology*,  pathology
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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