engleski

The frequency of nonsignificant extracranial stenosis of carotid arteries in symptomatic patients

The study included 140 stroke patients with mild and moderate extracranial artery stenosis diagnosed by means of color Doppler flow imaging (CDFI). Brain computed tomography (CT) scanning was done for each patient and risk factors were analysed. There were 12 (31%) female and 26 (69%) male patients, with the mean age 67.8 years. Risk factors were: hypertension (84%), and diabetes mellitus (28%). Thje stenosis of left, right or both carotid artery was found in 38 patients (28%). Mild and moderate stenosis of left carotid artery were found in 15 (11%), of right in 9(6%) and in 14(10%) patients of both carotid artery. The neurological examination pointed outthat in the group of the patients with stenosis of left carotid artery, 46% of patients had left side hemiparesi, 46 % had right side hemiparesis, while onepatient was dysphatic.The patients with stenosisof right carotid artery had almoat the same neurological picture.In the group of the patiernts who had stenosis of both carotid arteries, 50% had right sidehemiparesis, 21%had left side, 21% had dizziness, and 14 % hadthe signs of dementias.In the cases with similar stenosis of both carotid arteries, the neurological deficite of the right side was found in 75%.The half of patients with predominant stenosis of left carotid artery, in 50 % showed signes of dementia, 25 % had dizziness and paresis of left side was found in 25 %, while the patients with predominant stenosis of right carotid artery in 100 % had deficit of righr extremities. Brain CT findings showed ischemia of the arterial territory to be the most common sequele of not significant stenosis of one or both carotid artery 42% followed by multiple lesions in 34%, while the signs of periventricular hypoperfusion were found in 23 % of the patients. The nonsignificant carotid artery stenosis is often symptomatic, more than symptomatic carotid stenosis of the opposite side, so we point out the significance of hemodynamic role of the whole circle of Willis.

carotid stenosis; symptomatic patients; Doppler

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