INTRACRANIAL STENOSIS IN PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENTS

INTRODUCTION: This study was conducted to investigate pattern and risk factors associated with the location of atherosclerotic occlusive lesions in cerebral vessels. Previous studies of patients with stroke or transient ischemic attack (TIA) suggest that extracranial atherosclerosis is more common in the white race. Noninvasive techniques such as duplex ultrasound, transcranial Doppler (TCD), and magnetic resonance angiography (MRA) allow vascular assessment of a more representative proportion of the patients, compared to conventional angiography alone. METHODS: We evaluated patients with cerebrovascular problems (stroke and/or TIA) during a period of 6 months, using duplex ultrasonography, TCD and MRA to detect significant stenosis according to standard criteria. RESULTS: Stenosis of extracranial and intracranial arteries was detected in 38% and 29% of cases, respectively. MCA was the most frequent involved intracranial artery (11% bilaterally and 5% unilaterally). Intracranial lesions tend to be multiple. There was no significant difference between men and women in terms of frequency and distribution of stenosis. No correlation was found between opium use and stenosis. The women had significantly more poor windows than men (P<0.05). The extracranial stenosis was significantly more frequent than intracranial stenosis (P<0.01). CONCLUSION: The relations between hypertension and extracranial stenosis, and diabetes and MCA stenosis were statistically significant. TCD seemed to be a better technique for evaluating intracranial lesions in men than in women.