MR Angiographic Findings in Ischemic Stroke Patients with Extracranial Carotid Artery Stenosis

Lee, Dong Keun; Kwon, Young Joon; Lee, Seung Min; Yang, Jae Young; Choi, Chun Sik; Ju, Mun Bae

Abstract

OBJECTIVE
The purpose of study is to help the diagnosis and define the management of the ischemic stroke with carotid stenosis. We report a clinical analysis of the clinical and radiological characteristics of extracranial carotid artery stenosis in patients presenting with ischemic stroke using non-invasive technique, magnetic resonance(MR) angiography. METHODS: The authors reviewed 232 patients with ischemic stroke, excluding cardiac origin, carrying out MR image and MR angiography at department of neurology and neurosurgery from May 1998 to May 2001. Stroke in this study were classified as carotid and vertebro-basilar stroke. According to clinical and radiological finding, carotid stroke was divided into lacunar and non-lacunar stroke. The patients with extracranial carotid artery stenosis were classified according to the symptoms, location, and the degree of stenosis. The locations of intracranial lesion and associated intracranial stenosis were analyzed also. RESULTS: Of 232 stroke patients, 23(9.9%) had extracranial carotid artery stenosis. Symptomatic stenosis were 9 and 14 patients were non-symptomatic. The locations of stenosis were 10 in carotid bifurcation, 11 in proximal internal carotid artery, and 2 in common carotid artery. Severe intracranial stenosis were observed in 16 patients(69.6%) among 23 patients with extracranial carotid artery stenosis. CONCLUSION: Intracranial stenosis were frequently observed in ischemic stroke patients than extracranial lesions. And the combined extra- and intracranial atherosclerotic lesions were frequently seen in the patients with carotid artery stenosis. And these charactreristics should be considered in surgical management of ischemic stroke.