Prognosis of asymptomatic stenosis of the middle cerebral artery. Issue 9 (16th August 2004)

• Record Type: Journal Article
• Authors: Kremer, C; Schaettin, T; Georgiadis, D; Baumgartner, R W
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 75:Issue 9(2004)
• Page Start: 1300
• Page End: 1303
• Publication Date: 2004-08-16
• Subjects: MCAS, middle cerebral artery stenosis -- TCCS, transcranial colour duplex sonography; middle cerebral artery -- stenosis; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2003.017863
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: The risk of ischaemic events in asymptomatic intracranial atherosclerosis is unknown. Objective: To follow up patients with asymptomatic atherosclerotic middle cerebral artery stenosis (MCAS) to evaluate the long term stroke risk in its territory. Methods: Consecutive white patients with asymptomatic atherosclerotic MCAS were enrolled. Patients with MCAS of possible or proven non-atherosclerotic origin were excluded. MCAS was assessed by transcranial colour duplex sonography according to published angiography validated criteria. Medical treatment was given at the discretion of the treating physician. Results: 50 patients were included and followed for (mean (SD)) 815 (351) days; three were lost to follow up. MCAS was <50% in 38 and ⩾50% in 12. No patient suffered an ischaemic event in the MCAS territory; one had a transient ischaemic attack in the contralateral hemisphere. Three patients died, one from a subdural haematoma in the contralateral hemisphere, and two from non-stroke-related causes. Medical treatment at baseline included antithrombotic drugs in 42 cases (antiplatelet agent, n = 39; warfarin, n = 3), and statins in 22; at the end of follow up 45 of the 47 survivors were on antithrombotic drugs (antiplatelet agent, n = 37; warfarin, n = 8), and 30 were on statins. Conclusions: Asymptomatic MCAS of atherosclerotic origin appears to have a benign long term prognosis with a low risk of ipsilateral stroke in medically treated white patients.