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Benli MD, Güven B, Güven H, Conkbayır I. Silent brain infarcts and white matter lesions in patients with asymptomatic carotid stenosis. Acta Neurol Belg 2021; 121:983-991. [PMID: 33034830 DOI: 10.1007/s13760-020-01517-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
The association of carotid atherosclerosis with silent brain infarcts (SBIs) and white matter lesions (WMLs) currently remains unknown. This study aims to compare SBIs, deep white matter lesions (DWMLs), and periventricular white matter lesions (PWMLs) in ipsilateral and contralateral hemispheres to internal carotid artery (ICA) stenosis, and investigate their association with stenosis grade in patients with asymptomatic ≥ 50% unilateral extracranial ICA stenosis. Patients without previous history of stroke and/or transient ischemic attack who had ≥ 50% stenosis in unilateral ICA on carotid color Doppler ultrasound were enrolled in the study. Patient demographics, vascular risk factors and ICA stenosis grades; number, location, and size of SBIs, DWMLs, and PWMLs in ICA territory were evaluated in both hemispheres using magnetic resonance imaging of the brain. Of the 69 patients, 53 had 50-69% (76.8%) and 16 had ≥ 70% (23.2%) unilateral ICA stenosis. There was no statistically significant difference in SBIs between ipsilateral and contralateral hemispheres to ≥ 50% ICA stenosis. Comparison of ICA stenoses as 50-69% and ≥ 70% revealed a greater number of patients with SBI in ipsilateral hemisphere to ≥ 70% stenosis compared to contralateral (p = 0.025). The number of SBIs was also higher in ipsilateral hemisphere to ≥ 70% stenosis compared to contralateral (p = 0.022). While DWMLs and PWMLs did not differ between hemispheres, frequency of Fazekas grade 1 DWMLs was lower in ipsilateral hemisphere to either 50-69% or ≥ 70% ICA stenosis compared to contralateral (p = 0.035 and p = 0.025, respectively). Results of the present study indicate that stenosis grade may be relevant in the association between asymptomatic carotid stenosis and SBIs, and ≥ 70% stenosis may pose a risk of SBI development.
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Affiliation(s)
- Müjdat Deniz Benli
- Department of Neurology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Çiğdem mah. 1550/1 cad. 23/1 Çankaya, Ankara, Turkey
| | - Bülent Güven
- Department of Neurology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Çiğdem mah. 1550/1 cad. 23/1 Çankaya, Ankara, Turkey.
| | - Hayat Güven
- Department of Neurology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Çiğdem mah. 1550/1 cad. 23/1 Çankaya, Ankara, Turkey
| | - Işık Conkbayır
- Department of Radiology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Otani T, Irioka T, Takahashi YK, Soga K, Igarashi S, Kaneko K, Takahashi T, Yokota T. Two cases of late-onset neuromyelitis optica spectrum disorder initially presenting with isolated cerebral white matter lesions. eNeurologicalSci 2018; 13:35-37. [PMID: 30519648 PMCID: PMC6260276 DOI: 10.1016/j.ensci.2018.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/17/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Tai Otani
- Department of Neurology, Yokosuka Kyosai Hospital, Kanagawa, Japan.,Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Irioka
- Department of Neurology, Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - Yuko K Takahashi
- Department of Neurology, Yokosuka Kyosai Hospital, Kanagawa, Japan.,Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazumasa Soga
- Department of Neurology, Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - Susumu Igarashi
- Department of Neurology, Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - Kimihiko Kaneko
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurology, National Miyagi Hospital, Miyagi, Japan
| | - Toshiyuki Takahashi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurology, National Hospital Organization, Yonezawa Hospital, Yonezawa, Japan
| | - Takanori Yokota
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Fan Y, Lan L, Zheng L, Ji X, Lin J, Zeng J, Huang R, Sun J. Spontaneous white matter lesion in brain of stroke-prone renovascular hypertensive rats: a study from MRI, pathology and behavior. Metab Brain Dis 2015; 30:1479-86. [PMID: 26387009 DOI: 10.1007/s11011-015-9722-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
Hypertension is considered one of the most important controllable risk factors for white matter lesion (WML). Our previous work found that stroke-prone renovascular hypertensive rats (RHRSP) displayed a high rate of WML. This study aimed to investigate the WML in RHRSP from MRI, pathology and behavior. RHRSP model was established by two-kidney, two-clipmethod and kept for 20 weeks. WML was decteted by magnetic resonance imaging (MRI) and loyez staining. Cognition was tested by morris water maze (MWM). Vascular changes were observed by HE staining on brain and carotid sections. Ultrastucture of blood brain barrier (BBB) were observed by transmission electron microscope. Immunofluorescence was used to detect albumin leakage and cell proliferation. T(2)-weighted MRI scans of RHRSP displayed diffuse, confluent white-matter hyperintensities. Pathological examination of the same rat showed marked vacuoles, disappearence of myelin and nerve fibers in white matter, supporting the neuroimaging findings. Spatial learning and memory impairment were observed in RHRSP. The small arteries in brain exhibited fibrinoid necrosis, hyalinosis and vascular remodeling. BBB disruption and plasma albumin leakage into vascular wall was observed in RHRSP. Increased cell proliferation in subventricular zone was seen in RHRSP. RHRSP demonstrated spontaneous WML and cognitive impairment. Hypertensive small vessel lesions and BBB disruption might paly causative factors for the onset and development of WML. The characteristic features of WML in RHRSP suggested it a valid animal model for WML.
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Affiliation(s)
- Yuhua Fan
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China.
| | - Linfang Lan
- Department of Medicine and Therapeutics, Chinese University of Hongkong, Hongkong, China
| | - Lu Zheng
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Xiaotan Ji
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jing Lin
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jinsheng Zeng
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Ruxun Huang
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jian Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
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