Logo image
Back
Atherosclerotic Disease of the Cervical Carotid Artery: Evidence-Based Neuroimaging
Book chapter

Atherosclerotic Disease of the Cervical Carotid Artery: Evidence-Based Neuroimaging

Yasha Kadkhodayan, Colin P Derdeyn and Alex M Barrocas
Evidence-Based Neuroimaging Diagnosis and Treatment, pp.611-626
Evidence-Based Imaging, Springer New York
01/01/2013
DOI: 10.1007/978-1-4614-3320-0_37

View Online

Abstract

Extracranial carotid bifurcation atherosclerotic disease is associated with ischemic stroke. The carotid bifurcation, particularly the internal carotid artery near the bifurcation, is a preferred site for the development of atherosclerotic plaque. Several biomechanical and physiological factors are involved in the formation of atheroma at this location [1]. As atherosclerotic plaque builds, it can lead to ischemic stroke via two interrelated mechanisms: embolism and hemodynamic impairment. Embolism of plaque debris or thrombus that develops in or on the plaque may break free and lodge in a distal artery of the brain. Embolism likely accounts for the majority of stroke that occurs in association with carotid atherosclerosis. The second mechanism is that of low flow [2]. Depending on the adequacy of collateral flow, primarily determined by the status of the circle of Willis, severe stenosis may limit blood flow to the distal cerebral hemisphere. Significant hemodynamic impairment due to severe stenosis or occlusion at the carotid bifurcation is an independent predictor of stroke, likely due to synergistic effects with embolic events. Primary hemodynamic or low-flow stroke may also occur but is uncommon relative to primary embolic or synergistic embolic and hemodynamic mechanisms.
 Magnetic Resonance Angiography Compute Tomographic Angiography Internal Carotid Artery Carotid Stenosis Severe Stenosis

Details

Metrics

19 Record Views
Logo image