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ABSTRACT: The presence of carotid stenosis (CS) in a patient with lacunar stroke is usually considered an indication of atherosclerosis and not directly related to the development of this infarction subtype. This study was designed to determine the relationship between CS and lacunar infarction (LI) and to assess the differences between single and multiple LIs.
We classified 330 patients with a first-ever cerebral infarction in the carotid territory into LI and non-LI (NLI) groups. In the LI group, patients with a single LI and those with multiple LIs were identified. In this last subgroup, 2 patterns were identified: 1 subtype with lacunar lesions distributed in both cerebral hemispheres, and another with lesions predominantly in 1 hemisphere.
In the LI group, isolated CS was significantly more frequent on the homolateral side than on the contralateral side (odds ratio [OR], 5.5; 95% CI, 1.2 to 23; P=0.03). A significant relationship between the pattern of distribution of the infarctions in only 1 hemisphere and homolateral CS >70% was observed (OR, 4.4; 95% CI, 0.9 to 19; P=0.03). In a multivariate analysis, the following variables were found to predict unilateral multiple LI: left ventricular hypertrophy (OR, 9.1; 95% CI, 2.5 to 33.6) and homolateral CS >75% (OR, 14.4; 95% CI, 2.0 to 99.6).
The significant incidence of isolated ipsilateral CS in patients with LI located in the carotid territory and the relationship of CS to ipsilateral multiple LI suggest that CS has a very important role in the development of LI.
Stroke 06/2003; 34(6):1404-9. · 5.73 Impact Factor
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Annales de Chirurgie 06/2002; 127(5):402-3. · 0.35 Impact Factor
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ABSTRACT: Two cases of an unusual finding of capsular pseudoinvasion in follicular thyroid adenomas after fine-needle aspiration (FNA) procedures are reported. These capsular breaches were noted along the hemorrhagic needle track, which traversed the normal peripheral thyroid parenchyma into the lesions. A reparative reaction was seen at some points along one of the tracks. Histologic examination also showed extrusion of the tumor parenchyma through the capsular interruption in one case. Surgical pathologists should be aware of this rare complication of FNA of thyroid follicular adenomas as a differential diagnosis of minimally invasive (encapsulated) follicular carcinoma.
Diagnostic Cytopathology 11/1997; 17(4):295-7. · 1.16 Impact Factor
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ABSTRACT: Fibromuscular dysplasia (FMD) is a vasculopathy of unknown etiology generally presented in young women and preferentially found in the renal arteries. The second site of frequency of appearance corresponds to the cervical-cephalic arteries with cases of the intracranial vessels being exceptional. We recently had the opportunity to study a female patient of 29 years of age admitted following an acute progressive cerebrovascular event. Cranial computerized tomography (CT) demonstrated multiple ischemic lesions bilaterally affecting the basilar-vertebral territory. Angiographic study established the diagnosis of FMD upon observing "pearl-like" lesions located in the distal part of the basilar artery. Anticoagulant treatment was initiated and the patient evolved satisfactorily although some neurologic deficits persisted. The authors insist on the need to consider FMD as a cause of ictus in young, specially female, patients.
Neurologia (Barcelona, Spain) 05/1992; 7(4):77-80. · 0.79 Impact Factor
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ABSTRACT: Vasculitis is characterized by inflammation of the vessel walls, with or without necrosis, that causes narrowing and occasionally obstruction of the vessels. Vasculitis can be a primary process or it can occur secondary to other disease. Isolated central nervous system vasculitis (ICNSV) is a rare type of primary vasculitis that predominately affects the supratentorial regions. The clinical presentation and imaging findings are unspecific and diagnosis is made by exclusion and biopsy. We present a case manifesting as a pseudotumor in the posterior fossa on computed tomography and magnetic resonance imaging. The diagnosis was after biopsy, and the patient evolved favorably after treatment.
Radiología 48(5):309-12.
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ABSTRACT: Gastric pneumatosis is an infrequent entity. The clinical course may oscillate from an asymptomatic or mild condition (gastric emphysema) to a severe disorder with high mortality (emphysematous gastritis). Diagnosis with imaging techniques is based on radiological evidence of air in the gastric wall.
Gastroenterología y Hepatología 25(7):458-61. · 0.73 Impact Factor
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ABSTRACT: Perforating artery disease is still the main cause of lacunar infarcts (LI), while the relationship between this type of ischemia and carotid stenosis (CS) is controversial.
To assess the association between CS and LI in patients with criteria of localized ischemia in the carotid territory separately analyzing isolated LI and multiples LIs.
Three hundred and thirty patients with a first episode of cerebral infarct in the area supplied by the carotid artery were registered prospectively. There were 205 LI (135 isolated and 70 multiple) which could be differentiated from 125 non-lacunar infarcts (NLI). The vascular risk factors were determined and the degree of carotid stenosis measured by duplex-colour ultrasound exploration.
In the isolated LI group the frequency of presentation of CS greater than 50% was 22% for the artery ipsilateral to the LI and 8% for the contralateral artery. For significant CS (> 70%) frequencies of 14% (ipsilateral) and 8% (contralateral) were observed. On comparative analysis with the NLI group, the presence of stenosis greater than 50 to 70% was significantly higher in these for both ipsilateral and contralateral arteries. In the LI group, isolated CS was significantly more frequent on the side which was homolateral to the ischemia as compared to its isolated presence on the contralateral side (22/30 vs 4/12; OR: 5.5 [95% CI: 1.2-23]). Ipsilateral CS greater than 70% behaved as a factor which was significantly associated with the multiple LI subtype with a unilateral pattern.
CS should be considered a risk factor for LI.
Revista de neurologia 29(2):110-6. · 0.65 Impact Factor
