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Titolo:
BASE-LINE SILENT CEREBRAL INFARCTION IN THE ASYMPTOMATIC CAROTID ATHEROSCLEROSIS STUDY
Autore:
BROTT T; TOMSICK T; FEINBERG W; JOHNSON C; BILLER J; BRODERICK J; KELLY M; FREY J; SCHWARTZ S; BLUM C; NELSON JJ; CHAMBLESS L; TOOLE J; SEEGER J; BRUCK D; VOLD B; LAGUNA J; CHESSER M; ARCHER L; NICKOLS JR; MACDONALD C; HODAK J; FLOM R; HUNSLEY S; JAHNKE H; LEFKOWITZ D; SATTERFIELD J; COHEN S; JACOBS B; HOLGATE R; JOABOUR B; WALDEN K; VESCERA C; BERNSTEIN R; RADOSEVICH P; MCCORMICK P; ELIAS L; FURLAN A; BRYERTON B; SAUERBECK S; MOHR JP; PETTY G; LIBMAN R; MARSHALL R; CRUZ A; GONZALEZ T; CABRERA A; EARLY C; STONE B; MAGUIRE MP; SCHECTER J; CAPPS R; GLASS J; FARRAR N; PATEL S; WILCZEWSKI J; ROBERTSON W; DALEY S; JANESKY C; MEILSTRUP J; FRIEDMAN D; SMITH F; BEDARD F; ADAMS H; LOVE B; BENDIXEN B; VINING L; KARBOSKI D; GRIMSMAN K; LEE C; YOUNG B; PETTIGREW C; DEMPSEY R; SADLER R; RICE L; DIANA L; NORTON A; LIN ZS; LANGENECKER J; JENNY D; GUPTA S; BURKE K; WARNER J; LOBNER S; TAYLOR J; COCKRELL A; CONWAY C; SMITH R; BROWN R; WEISBROT F; KAMIN S; BACK T; ROGERS C; BRUNO A; JOHNSON E; STEEL S; YAO J; CHADWICK L; HUGHES R; LEPLER B; LANG V; BENOIT C; CAHANIN V; TAYLOR L; COULL B; WHITAKER L; DALMAN R; BIVINS D; FOLEY C; GREEN R; COHEN D; MCNAMARA J; LEVINE R; HURLEY J; WILCOX M; BLACKBURN C; MESTAYER R; ALMOND C; CLAGETT GP; UNWIN H; BRYAN W; MATKINS C; COOPER P; ROWED D; BOWYER B; ROBERTSON J; VASU K; ACKER J; BRADLEY A; RILEY J; CONNELL J; GIAMPAPA MA; TAYLOR C; STAHL N; THOMAS T; BENNETT S; FOX A; MAYER C; WHITE C; ASSIS L; PEXMAN W; PADDOCK L; CRANE R; HARRIS S; BUTTERLEVY K; BRASS L; FAYAD P; SUMPIO B; LOVEJOY A; KISIEL D; TOOLE JF; HOWARD VJ; PURVIS S; VERNON DD; NEEDHAM K; BECK P; DOZIER M; HOWARD G; ESSICK K; CHAMBLESS LE; BLAND E; LOCKLEAR J;
Indirizzi:
UNIV CINCINNATI,MED CTR,DEPT NEUROL,231 BETHESDA AVE CINCINNATI OH 45267 ARIZONA HLTH SCI CTR TUCSON AZ 00000 FRANCIS SCOTT KEY MED CTR BALTIMORE MD 00000 NORTHWESTERN UNIV,SCH MED CHICAGO IL 00000 LOYOLA UNIV,MED CTR MAYWOOD IL 60153 BARROW NEUROL INST PHOENIX AZ 00000 UNIV ARIZONA TUCSON AZ 00000 UNIV ARKANSAS LITTLE ROCK AR 00000 UNIV CALIF LOS ANGELES LOS ANGELES CA 00000 CALIF PACIFIC MED CTR SAN FRANCISCO CA 00000 CLEVELAND CLIN CLEVELAND OH 00000 COLUMBIA UNIV NEW YORK NY 00000 HARBIN CLIN ROME GA 00000 HENRY FORD HOSP DETROIT MI 00000 PENN STATE UNIV,MILTON S HERSHEY MED CTR HERSHEY PA 17033 HOP ENFANTS JESUS QUEBEC CITY PQ CANADA UNIV IOWA IOWA CITY IA 00000 UNIV KENTUCKY LEXINGTON KY 00000 LEHIGH VALLEY HOSP ALLENTOWN PA 00000 MARSHFIELD CLIN FDN MED RES & EDUC MARSHFIELD WI 00000 VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA RICHMOND VA 23298 UNIV MISSISSIPPI JACKSON MS 00000 TUFTS UNIV NEW ENGLAND MED CTR BOSTON MA 00000 UNIV MED & DENT NEW JERSEY NEWARK NJ 00000 UNIV NEW MEXICO ALBUQUERQUE NM 00000 OCSHNER CLIN NEW ORLEANS LA 00000 OREGON HLTH SCI UNIV PORTLAND OR 00000 ROANOKE NEUROL CTR ROANOKE VA 00000 UNIV ROCHESTER ROCHESTER NY 00000 ST JOHNS MERCY MED CTR ST LOUIS MO 00000 SINGING RIVER HOSP PASCAGOULA MS 00000 UNIV TEXAS,SW MED CTR DALLAS TX 00000 SUNNYBROOK MED CTR TORONTO ON CANADA UNIV TENNESSEE MEMPHIS TN 00000 UNIV WESTERN ONTARIO HOSP LONDON ON CANADA VICTORIA HOSP LONDON ON CANADA VIRGINIA MASON CLIN SEATTLE WA 00000 YALE UNIV,SCH MED NEW HAVEN CT 00000 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT NEUROL WINSTON SALEM NC 27103 UNIV N CAROLINA,DEPT BIOSTAT CHAPEL HILL NC 00000
Titolo Testata:
Stroke
fascicolo: 6, volume: 25, anno: 1994,
pagine: 1122 - 1129
SICI:
0039-2499(1994)25:6<1122:BSCIIT>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSIENT ISCHEMIC ATTACKS; CHRONIC ATRIAL-FIBRILLATION; COMPUTED-TOMOGRAPHY; STROKE; ENDARTERECTOMY;
Keywords:
CAROTID ARTERY DISEASES; CEREBRAL INFARCTION; CLINICAL TRIALS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
T. Brott et al., "BASE-LINE SILENT CEREBRAL INFARCTION IN THE ASYMPTOMATIC CAROTID ATHEROSCLEROSIS STUDY", Stroke, 25(6), 1994, pp. 1122-1129

Abstract

Background and Purpose In a group of patients with high-grade asymptomatic carotid artery stenosis, we prospectively determined the prevalence and radiological characteristics of clinically asymptomatic brain infarction evident on computed tomography. Risk factors and extent of carotid disease were also determined. Methods Patients randomized intothe Asymptomatic Carotid Atherosclerosis Study (ACAS) underwent a neurological history, a detailed stroke/transient ischemic attack question naire, and a detailed neurological examination. Computed tomography scans were examined by standardized criteria developed as part of a quality-control program supervised by a neuroradiologist. The presence, location, and size of all cerebral infarctions evident by computed tomography were determined. Results Among 1132 patients, 848 had no history of stroke or transient ischemic attack. One hundred twenty-six patients (15%) had a silent infarct; 95 (11%) had one, 24 (3%) had two, and 7 (1%) had three or more infarcts. The infarct size was small and deep for 117 patients (72%), less than one-half lobe for 45 (28%), and one-half to less than one lobe for 1 (0.5%). The silent infarcts were evenly distributed ipsilaterally and contralaterally to the study artery but were significantly more frequent in the right hemisphere (P<.05). Factors associated with silent infarction were abnormal gait (P<.001), abnormal deep tendon reflexes or plantar responses (P=.038), but not degree of carotid stenosis. Silent infarction was less frequent among this totally asymptomatic cohort (15%) compared with those with transient ischemic attacks (34/139, 25%; P<.001). Conclusions Silent infarction in the setting of asymptomatic carotid stenosis is not uncommon,but silent infarctions are rarely sizable. The clinical significance of silent cerebral infarction in patients with asymptomatic carotid artery stenosis has yet to be established.

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Documento generato il 25/11/20 alle ore 07:35:44