Extracranial carotid artery wall abnormalities in patients with acute ischemic stroke

Authors

  • Akhilesh Kumar Nunavath Department of Neurology, Osmania General Hospital, Osmania Medical College, Hyderabad, India
  • Sandhya Manorenj Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, India http://orcid.org/0000-0003-4699-3645
  • Srikant Jawalkar Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, India Srikanth Ortho and Neuro centre, Hyderabad, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20221484

Keywords:

Carotid artery, Stroke, Intima

Abstract

Background: Stroke is the second most common cause of mortality worldwide. Large artery extracranial atherosclerosis is one of the major causes of ischemic stroke. The present study laid emphasizes on causal relationship between the carotid wall abnormalities and occurrence of ischemic stroke. The aim and objectives of the study were to estimate the prevalence of carotid artery wall abnormalities in acute ischemic stroke patients and assessment of association between carotid wall abnormalities and vascular risk factors.

Methods: A cross-sectional observational study was conducted in department of neurology for a period of two years. Cases with acute ischemic stroke were included in the study. Carotid Intima media thickness (CIMT) was measured using carotid duplex ultrasound scanning at the level of carotid bifurcation.

Results: CIMT findings was abnormal in 87% of cases where the thickness was ≥0.8 mm. 38% of patients with Ischemic stroke had CIMT ≥1.2 mm. Mean CIMT was highest in patients with sedentary life style (CIMT-1.18 mm) and the differences were significant when compared to non-sedentary life style group. CIMT values were higher in patients with age 61-80 years (CIMT: 2.1 mm); with multiple vascular risks like diabetes and hypertension (CIMT: 1.16 mm); with diabetes mellitus alone (CIMT: 1.14 mm) and hypertension alone (CIMT-1.13 mm) respectively.

Conclusions: Highest mean CIMT value were observed in older adults with age range of 61 to 80 years. Individuals with sedentary life style habits and multiple vascular risk factors had higher mean CIMT value. Early identification of abnormal CIMT value combined with appropriate treatment can prevent stroke in future.

Author Biographies

Akhilesh Kumar Nunavath, Department of Neurology, Osmania General Hospital, Osmania Medical College, Hyderabad, India

Neurology Department,Assistant Professor

Sandhya Manorenj, Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, India

 Professor and Head

Department of Neurology

Srikant Jawalkar, Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, India Srikanth Ortho and Neuro centre, Hyderabad, India

Neurology Department

Senior Consultant

References

Sahoo R, Krishna MV, Subrahmaniyan DK, Dutta TK, Elangovan S. Common carotid intima-media thickness in acute ischemic stroke: A case control study. Neurol India. 2009;57(5):627-30.

Mukherjee SC, Basu AK, Bandyopadhyay R, Pal SK, Mandal SK et al. Correlation of lipid profile and carotid artery plaque as detected by doppler ultrasound in ischemic stroke patients: A hospital-based study. J Indian Med Assoc. 2006;104:325-6.

Saxena Y, Saxena V, Mittal M, Srivastava M, Raghuvanshi S. Age-Wise Association of Carotid Intima Media Thickness in Ischemic Stroke. Ann Neurosci. 2017;24(1):5-11.

Den Ruijter HM, Peters SAE, Anderson TJ. Common Carotid Intima-Media Thickness Measurements in Cardiovascular Risk Prediction: A Meta-analysis. JAMA. 2012;308(8):796-803.

Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J. Intima-media thickness: A new tool for diagnosis and treatment of cardiovascular risk. J Hypertens. 2002;20:159-69.

Wikstrand J, Wendelhag I. Methodological considerations of ultrasound investigation of intima-media thickness and lumen diameter. J Intern Med. 1994;236:555-9.

Bluth EI, Stavros AT, Marich KW, Wetzner SM, Aufrichtig D, Baker JD. Carotid duplex sonography: a multicenter recommendation for standardized imaging and Doppler criteria. Radiographics. 1988;8(3):487-506.

Lindsberg PJ, Roine RO. Hyperglycemia in Acute Stroke. Stroke. 2004;35(2):363-4.

Mannami T, Iso H, Baba S, Sasaki S, Okada K, Konishi M et al. Japan Public Health Center-Based Prospective Study on Cancer and Cardiovascular Disease Group. Cigarette smoking and risk of stroke and its subtypes among middle-aged Japanese men and women: the JPHC Study Cohort I. Stroke. 2004;35(6):1248-53.

Bowman TS, Sesso HD, Ma J, Kurth T, Case CS, Stampher MJ, Gazino JM. Cholestrol and Risk of Ischemic Stroke. 2003;34(12):2930-4.

Fernandes M, Keerthiraj B, Mahale AR, Kumar A, Dudekula A. Evaluation of carotid arteries in stroke patients using color Doppler sonography: A prospective study conducted in a tertiary care hospital in South India. Int J Appl Basic Med Res. 2016;6(1):38-44.

Sun P, Liu L, Liu C, Zhang Y, Yang Y, Qin X et al. Carotid Intima-Media Thickness and the Risk of First Stroke in Patients with Hypertension. Stroke. 2020;51(2):379-86.

Downloads

Published

2022-05-27

How to Cite

Nunavath, A. K., Manorenj, S., & Jawalkar, S. (2022). Extracranial carotid artery wall abnormalities in patients with acute ischemic stroke. International Journal of Research in Medical Sciences, 10(6), 1291–1296. https://doi.org/10.18203/2320-6012.ijrms20221484

Issue

Section

Original Research Articles