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題名 | Correlation of Common Carotid Artery Intima Media Thickness, Intracranial Arterial Stenosis and Post-stroke Cognitive Impairment=總頸動脈內膜厚度及顱內動脈狹窄與中風後認知功能的關係 |
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作者 | 李詠慧; 葉守正; | 書刊名 | Acta Neurologica Taiwanica |
卷期 | 16:4 2007.12[民96.12] |
頁次 | 頁207-213 |
分類號 | 415.922 |
關鍵詞 | 內膜厚度; 動脈狹窄; 中風; Common carotid artery intima-media thickness; Intracranial arterial stenosis; Vascular cognitive impairment; Acute ischemic stroke; |
語文 | 英文(English) |
英文摘要 | Background and Purpose: Atherosclerosis of the intracranial arteries is a well-recognized cause of ischemic stroke in Asians, and extracranial carotid artery disease is more often seen in western countries. The relationship of common carotid artery intima-media thickness (CCA-IMT), intracranial arteries stenosis (ICS) and vascular cognitive impairment (VCI) after ischemic stroke has not been fully elucidated. In this study, we investigated the relationship between CCA-IMT and the severity of ICS and VCI. Methods: We recruited patients from December 2004, to June 2005, with the inclusion criteria: (1) first-ever ischemic stroke, (2) admission within 3 days of stroke onset, (3) under 80 years old, and (4) no previous dementia history. We excluded patients with stroke scores greater than an NIHSS of 15; those with recurrent stroke, and those with extracranial internal carotid artery stenosis >50%. All the patients underwent brain MR angiography, carotid ultrasonography and neuropsychological testing during hospitalization and at 3 months after stroke. We defined the percent of ICS using the method of Warfarin-Aspirin Symptomatic Intracranial Disease. Measurement of CCA-IMT was made on the far wall of the common carotid artery, 1.5 cm proximal to the bifurcation at a point free of plaques. Cognitive performance was assessed using the Cognition Assessment State Instrument (CASI). Results: Thirty patients (21M/9F, mean age 65.97Ų10.33 years) were studied. The initial CCA-IMT was 1.04Ų0.59 mm and the initial CASI was 64.73Ų14.75. The ICS was 70Ų26%. At 3 months after stroke, the CCA-IMT was 1.06Ų0.59 mm; and CASI was 70.07Ų18.50. Compared with patients with CCA-IMT > 0.87 mm, those with CCA-IMT ≤ 0.87 mm had lower ICS (57Ų23% vs. 81Ų24%, p = 0.013), but similar initial CASI score (67.92Ų13.52 vs. 61.93Ų16.64, p = 0.28). The improvement of CASI score at 3 months was significantly higher in patients with CCA-IMT ≤ 0.87 mm (67.92Ų 13.52 vs. 77.36Ų14.12, p = 0.001), than those with CCA-IMT > 0.87 mm (61.93Ų16.64 vs. 63.69Ų 19.89, p = 0.612). Conclusions: CCA-IMT might be associated with the severity of ICS and VCI at 3 months after the first-ever ischemic stroke. The patients with lower CCA-IMT had a better CASI evaluation at 3 months after stroke. A larger scale of study to explore the association of CCA-IMT, VCI and ICS at 3 months after stroke might help farther delineation of these relationships. |
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