title: Carotid artery intima-media thickness associated with prognosis of intracranial branch atheromatous disease.
abstract: OBJECTIVE
  Small deep brain infarcts are often caused by two different vascular pathologies: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). In this study, we compare the clinical characteristics of BAD and LD and investigate the role of C-reactive protein (CRP), homocysteine (Hcy), and carotid artery intima-media thickness (IMT) in the prognosis of patients with BAD and LD.
  
  
  METHODS
  Of 262 adult patients with small deep infarcts, 104 were considered BAD and 158 were considered LD. Data compared included clinical information, prevalence of lacune and leukoaraiosis, Hcy, CRP, carotid artery IMT, deterioration during admission, and recurrence of ischemic stroke (IS) within 1 year.
  
  
  RESULTS
  Patients with LD have severe leukoaraiosis and higher prevalence of lacune and intracerebral hemorrhage compared with those with BAD. Patients with BAD have higher initial National Institutes of Health Stroke Scale scores and incidence of progressive motor deficits compared with those with LD; CRP is associated with the progression in both groups. There is no statistical difference of recurring risk of IS within 1 year between the two groups; by multivariable logistic regression analysis, carotid artery IMT was an independent risk factor for recurrence of IS in 1 year in patients with BAD.
  
  
  CONCLUSIONS
  BAD as an independent clinical entity has different clinical and radiological characteristics compared with LD. Carotid artery IMT is an independent risk factor for recurrence of IS in patients with BAD.
authors.affiliation: a Department of Neurology , Shanghai No.5 Hospital, Fudan University , Shanghai , China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Duan
authors.affiliation: b Department of Gerontology , Shanghai No.5 Hospital, Fudan University , Shanghai , China.
authors.forename: Shan
authors.initials: S
authors.lastname: Zhang
authors.affiliation: b Department of Gerontology , Shanghai No.5 Hospital, Fudan University , Shanghai , China.
authors.forename: Liang
authors.initials: L
authors.lastname: Li
authors.affiliation: a Department of Neurology , Shanghai No.5 Hospital, Fudan University , Shanghai , China.
authors.forename: Chuancheng
authors.initials: C
authors.lastname: Ren
authors.affiliation: b Department of Gerontology , Shanghai No.5 Hospital, Fudan University , Shanghai , China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xie
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D000072226:Computed Tomography Angiography; D018450:Disease Progression; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000068079:Motor Disorders / Q000209:etiology; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein
keywords: C-reactive protein; branch atheromatous disease; carotid artery intima-media thickness; cerebral vascular disease; stroke