PDF(Pubmed)
Abstract：
(1) Background: Non-stenotic complicated plaques are a neglected cause of stroke, in particular in young patients. Atherosclerosis has some preferential sites in extracranial arteries and the prepetrous segment of the internal carotid artery has been rarely described as site of atheroma in general and of complicated atheroma in stroke patients. The aim of this study is to describe the rate of the prepetrous internal carotid artery\'s (ICA) involvement in a single-center case series of young stroke patients. (2) Methods: All patients < 50 years old with acute ischemic stroke admitted to a single-center Stroke Unit during two time periods (the first one from 1 January 2018 to 31 December 2019, and the second one from 1 January 2021 to 30 June 2022), were prospectively investigated as part of a screening protocol of the Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO) study [ClinicalTrials.gov ID NCT01934725], including extracranial vascular examination by using computed tomography (CT) or magnetic resonance imaging (MRI). (3) Results: Two out of ninety-three consecutive patients (2.15%) had a complicated atheroma in the prepetrous ICA as the cause of stroke and both CT angiography and high-resolution vessel wall MRI were applied to document the main features of positive remodeling, cap rupture, ulceration, intraplaque hemorrhage, and a transient thrombus superimposed on the atheroma. The two patients had a different evolution of healing in the first case and a persisting ulceration at 12 months in the second case. (4) Conclusions: The prepetrous ICA is a rarely described location of complicated atheroma in stroke patients at all ages and it represents roughly 2% of causes of acute stroke in this single-center case series in young people.
摘要：
(1)背景:非狭窄复杂斑块是脑卒中的一个被忽视的原因,尤其是年轻患者。动脉粥样硬化在颅外动脉中有一些优先部位，颈内动脉的前段很少被描述为一般的动脉粥样硬化部位和中风患者的复杂动脉粥样硬化部位。这项研究的目的是描述在单中心病例系列的年轻中风患者中颈内动脉（ICA）的累及率。（2）方法：所有年龄<50岁的急性缺血性卒中患者在两个时间段（第一个从2018年1月1日至2019年12月31日，第二个从2021年1月1日至2022年6月30日）入住单中心卒中单元。作为寻找青年隐源性中风解释的筛查方案的一部分进行前瞻性调查：揭示病因，触发器,和结果（SECRETO）研究[ClinicalTrials.govIDNCT01934725]，包括使用计算机断层扫描（CT）或磁共振成像（MRI）进行颅外血管检查。（3）结果：在93例连续患者中，有2例（2.15％）在前ICA中具有复杂的动脉粥样硬化作为中风的原因，并应用CT血管造影和高分辨率血管壁MRI来记录主要特征。阳性重塑，帽破裂,溃疡,斑块内出血,和动脉粥样硬化上叠加的一过性血栓.在第一种情况下，两名患者的愈合进展不同，在第二种情况下，在12个月时持续溃疡。（4）结论：在所有年龄段的中风患者中，前ICA是一个很少描述的复杂动脉粥样硬化的位置，在年轻人的单中心病例系列中，它约占急性中风原因的2％。
