title: Temporal changes of ulcerative plaques in the aortic arch in recurrent stroke patients.
abstract: BACKGROUND
  Ulcerative aortic plaques (UAPs) are considered a major source of brain embolism. However, whether UAPs contribute to a specific stroke mechanism remains unknown.
  
  
  METHODS
  Three consecutive patients with recurrent embolic stroke underwent repeated transesophageal echocardiography (TEE) examinations after their initial and recurrent strokes.
  
  
  RESULTS
  All 3 patients had UAPs. Between TEEs, different morphologies of UAPs were found in cases 1 and 2, and case 3 maintained advanced UAPs with no significant morphological alteration. Case 3 underwent repeated contrast-enhanced computed tomographic examinations after each stroke event, which showed newly developed, uneven, ulcerative plaques in the aortic arch after recurrent stroke.
  
  
  CONCLUSIONS
  Repeated TEE showed dynamic changes of UAPs in recurrent stroke patients and supported the diagnosis of aortogenic brain embolism.
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Urayasu, Chiba. Electronic address: yuji-u@juntendo.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ueno
authors.forename: Masao
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Takuma
authors.initials: T
authors.lastname: Kuroki
authors.forename: Naohide
authors.initials: N
authors.lastname: Kurita
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimura
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Takao
authors.initials: T
authors.lastname: Urabe
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis; D001027:Aortography / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000150:complications* / Q000175:diagnosis
keywords: Aortogenic brain embolism; atheromatous aortic plaque; recurrent ischemic stroke; transesophageal echocardiography; ulcerative aortic plaque