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The Protective Effect of Middle Cerebral Artery Calcification on Symptomatic Middle Cerebral Artery Infarction

 Jang-Hyun Baek  ;  Joonsang Yoo  ;  Dongbeom Song  ;  Young Dae Kim  ;  Hyo Suk Nam  ;  Ji Hoe Heo 
 STROKE, Vol.48(11) : 3138-3141, 2017 
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Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Infarction, Middle Cerebral Artery*/epidemiology ; Infarction, Middle Cerebral Artery*/pathology ; Infarction, Middle Cerebral Artery*/physiopathology ; Intracranial Arteriosclerosis*/epidemiology ; Intracranial Arteriosclerosis*/pathology ; Intracranial Arteriosclerosis*/physiopathology ; Male ; Middle Aged ; Middle Cerebral Artery*/pathology ; Middle Cerebral Artery*/physiopathology ; Registries* ; Retrospective Studies ; Vascular Calcification*/epidemiology ; Vascular Calcification*/pathology ; Vascular Calcification*/physiopathology
atherosclerosis ; intracranial stenosis ; stroke ; vascular calcification
BACKGROUND AND PURPOSE: The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification.

METHODS: We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory. Patients with any stenotic MCAs were included in this study. Symptomatic MCA was defined as the occurrence of infarctions relevant to the stenotic MCA. The presence of calcification in the MCA was evaluated on noncontrast thin-section computed tomography images using a 3dimensional software package. Generalized estimating equations were used to compare the frequency of calcification between symptomatic and asymptomatic stenosis.

RESULTS: Of the 1066 MCAs examined in 533 patients, 645 MCAs were stenotic and were included in the study. Among the 645 stenotic MCAs, 406 MCAs (62.9%) were symptomatic. Calcification was observed in 36 MCAs (5.6%). Calcification in the MCA was more frequently observed in the asymptomatic group (7.9% versus 4.2%; P=0.032). On multivariable analysis, the presence of calcification in MCA atherosclerosis was less frequent in the symptomatic group (odds ratio, 0.46; 95% confidence interval, 0.23-0.92; P=0.027).

CONCLUSIONS: This study showed that calcified atherosclerosis in the MCA was less frequently symptomatic.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Baek, Jang Hyun(백장현)
Song, Dong Beom(송동범)
Yoo, Joon Sang(유준상) ORCID logo https://orcid.org/0000-0003-1169-6798
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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