Immediate regression of leukoaraiosis after carotid artery revascularization. 2011

Yu-Ming Chuang, and Kuo-Lun Huang, and Yeu-Jhy Chang, and Chien-Hung Chang, and Ting-Yu Chang, and Tai-Cheng Wu, and Ho-Fai Wong, and Shan-Jin Liu, and Tsong-Hai Lee
Department of Neurology, Far-Eastern Memorial Hospital, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.

BACKGROUND Leukoaraiosis (LA) affects cognition after stroke and reversal of LA may improve cognitive performance. We aimed to determine the impact of cerebral perfusion and circle of Willis (CoW) flow patterns on the extent of LA after carotid artery revascularization. METHODS LA was scored on fluid-attenuated inversion recovery magnetic resonance (MR) images at the levels of the centrum semiovale and frontal horns in both cerebral hemispheres of 62 contiguous patients (men/women = 38/24, mean age = 63.2 ± 8.4 years, range 44-82) before and after unilateral carotid artery revascularization. The pre- and poststenting differences in LA scores, CoW flow pattern on MR angiography, and MR perfusion parameters were analyzed. RESULTS The total LA score decreased from 9.87 ± 0.65 to 8.33 ± 0.72 after stenting (p = 0.03). The CoW was complete in 21 subjects and incomplete in 41 subjects. The incomplete CoW group had a higher preoperative LA load and higher cerebral interhemispheric asymmetry index, both of which decreased significantly postoperatively. CONCLUSIONS CoW anomalies may contribute to LA in patients with carotid artery stenosis, and restoration of cerebral perfusion by carotid artery revascularization can reduce LA severity.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D002339 Carotid Arteries Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery. Arteries, Carotid,Artery, Carotid,Carotid Artery
D002548 Cerebral Revascularization Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain. Brain Revascularization,EC-IC Arterial Bypass,Extracranial-Intracranial Arterial Bypass,Microsurgical Revascularization, Cerebral,STA-MCA Bypass,Cerebral Microsurgical Revascularization,Arterial Bypass, EC-IC,Arterial Bypass, Extracranial-Intracranial,Arterial Bypasses, EC-IC,Arterial Bypasses, Extracranial-Intracranial,Bypass, EC-IC Arterial,Bypass, Extracranial-Intracranial Arterial,Bypass, STA-MCA,Bypasses, EC-IC Arterial,Bypasses, Extracranial-Intracranial Arterial,Bypasses, STA-MCA,Cerebral Microsurgical Revascularizations,EC IC Arterial Bypass,EC-IC Arterial Bypasses,Extracranial Intracranial Arterial Bypass,Extracranial-Intracranial Arterial Bypasses,Revascularization, Brain,Revascularization, Cerebral,Revascularization, Cerebral Microsurgical,STA MCA Bypass,STA-MCA Bypasses
D002560 Cerebrovascular Circulation The circulation of blood through the BLOOD VESSELS of the BRAIN. Brain Blood Flow,Regional Cerebral Blood Flow,Cerebral Blood Flow,Cerebral Circulation,Cerebral Perfusion Pressure,Circulation, Cerebrovascular,Blood Flow, Brain,Blood Flow, Cerebral,Brain Blood Flows,Cerebral Blood Flows,Cerebral Circulations,Cerebral Perfusion Pressures,Circulation, Cerebral,Flow, Brain Blood,Flow, Cerebral Blood,Perfusion Pressure, Cerebral,Pressure, Cerebral Perfusion
D002941 Circle of Willis A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries. Cerebral Arterial Circle,Willis' Circle,Arterial Circle, Cerebral,Circle, Willis',Willis Circle
D003072 Cognition Disorders Disorders characterized by disturbances in mental processes related to learning, thinking, reasoning, and judgment. Overinclusion,Disorder, Cognition,Disorders, Cognition
D005260 Female Females

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