Is there a side predilection for cerebrovascular disease?
In studies on carotid artery intima-media thickness and stroke, researchers implicitly assume that cerebrovascular abnormalities show a symmetrical distribution. To evaluate whether there is a difference in intima-media thickness between the 2 carotids, we compared left and right common carotid artery intima-media thickness as measured by B-mode ultrasonography in a group of 102 untreated hypertensive patients. This yielded a significant difference between both sides (left, 0.75+/-0.11 mm; right, 0.71+/-0.11 mm; P<0.001). This was associated with a higher cross-sectional area of the intima-media complex and a higher flow velocity at the left side. Arterial diameters, however, were not different. We also assessed whether there is a side preference with respect to cerebrovascular accidents. To this end, we explored our population-based Stroke Registry of 1843 subjects and indeed found a significantly higher incidence of nonlacunar cerebrovascular stroke at the left side, whereas lacunar infarcts were symmetrically distributed. Our findings suggest a predilection for cerebrovascular disease at the left side, which may be related to greater hemodynamic stress and intimal damage in the left carotid artery.
Rodríguez Hernández
Sergio A
SA
Department of Internal Medicine, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht, The Netherlands.
Kroon
Abraham A
AA
van Boxtel
Martin P J
MP
Mess
Werner H
WH
Lodder
Jan
J
Jolles
Jelle
J
de Leeuw
Peter W
PW
D000328:Adult; D000368:Aged; D017536:Carotid Artery, Common / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography