High-grade internal carotid artery stenosis and chronic brain damage: a volumetric magnetic resonance imaging study.
BACKGROUND
Experimental data suggest that high-grade vascular stenosis may induce chronic cerebral tissue damage.


METHODS
We tested this hypothesis in 97 patients with a ≥70% unilateral internal carotid artery (ICA) stenosis (mean age: 69.1 ± 10.2 years), comparing intraindividual side-to-side differences in hemispheric brain and white matter hyperintensity (WMH) volumes. Patients with a supratentorial infarct exceeding 1.5 cm in diameter were excluded.


RESULTS
Overall, the median WMH volume was greater in the hemisphere ipsilateral to the stenotic ICA (1.13 ± 2.65 vs. 0.77 ± 2.26 cm³; p = 0.005), but there were no differences in hemispheric brain volumes between the stenotic and nonstenotic sides. In the subgroup of patients with moderate and severe WMH (n = 41), the hemispheric volume ipsilateral to the stenotic ICA was significantly smaller (543.46 ± 22.17 vs. 548.66 ± 26.7 cm³; p = 0.03). Multivariate linear regression analysis revealed an independent effect of WMH grade on interhemispheric volume differences relative to the side of stenosis.


CONCLUSIONS
Chronic tissue damage may occur in a subset of individuals with ≥70% ICA stenosis, globally exhibiting more extensive WMH.
Department of Neurology, Medical University of Graz, Graz, Austria.
Christian
C
Enzinger
Stefan
S
Ropele
Thomas
T
Gattringer
Christian
C
Langkammer
Reinhold
R
Schmidt
Franz
F
Fazekas
D000368:Aged; D000704:Analysis of Variance; D001317:Austria; D001927:Brain Diseases / Q000209:etiology / Q000473:pathology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D054022:Cerebrum / Q000473:pathology*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D006801:Humans; D016014:Linear Models; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex