Tábuas-Pereira Miguel, Sargento-Freitas João, Silva Fernando, Parra Joana, Mendes Patrícia, Seara Vera, Mesquita Miguel, Baptista Mariana, Cordeiro Gustavo, Cunha Luis
Stroke Unit, Centro Hospitalar e Universitário de Coimbra, CHUC, Coimbra, Portugal.
Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, CHUC, Coimbra, Portugal.
Eur Neurol. 2018;79(1-2):21-26. doi: 10.1159/000477901. Epub 2017 Nov 13.
Calcifications are an important element of atherosclerotic plaques and have been used as a marker of atherosclerosis and clinical outcome predictor in different vascular territories. CT-scan, performed in the acute ischemic stroke setting, can reliably detect intracranial arterial calcifications.
To investigate the association between intracranial internal carotid artery calcification and functional outcome, symptomatic intracerebral hemorrhage (sICH), recanalization, and death.
We included 396 consecutive ischemic stroke patients submitted to recombinant tissue plasminogen activator treatment between January 2011 and September 2014. Admission CT-scans were reviewed to calculate the Total Carotid Syphon Calcification score. Patients were followed for up to at least 6 months post-stroke or until death. Outcome measures included evaluation of recanalization on the first 24 h (transcranial color coded Doppler or angio-CT), sICH, and assessment of functional outcome at 3 months after stroke (using modified Rankin scale).
Carotid artery wall calcification did not predict sICH, recanalization or any good outcome. However, it was a statistically significant predictor of death (OR 1.102, 95% CI [1.004-1.211], p = 0.042).
Intracranial carotid artery calcification does not increase the risk of thrombolysis-induced sICH. Patients with higher grade of carotid artery wall calcification may have a higher mortality rate.
钙化是动脉粥样硬化斑块的重要组成部分，已被用作不同血管区域动脉粥样硬化的标志物和临床结局预测指标。在急性缺血性卒中情况下进行的CT扫描能够可靠地检测颅内动脉钙化。
研究颅内颈内动脉钙化与功能结局、症状性脑出血（sICH）、再通及死亡之间的关联。
我们纳入了2011年1月至2014年9月间接受重组组织型纤溶酶原激活剂治疗的396例连续缺血性卒中患者。回顾入院时的CT扫描以计算总颈动脉虹吸部钙化评分。对患者进行至少卒中后6个月的随访或直至死亡。结局指标包括评估卒中后24小时内的再通情况（经颅彩色编码多普勒或血管CT）、sICH，以及卒中后3个月时的功能结局评估（采用改良Rankin量表）。
颈动脉壁钙化不能预测sICH、再通或任何良好结局。然而，它是死亡的统计学显著预测指标（比值比1.102，95%置信区间[1.004 - 1.211]，p = 0.042）。
颅内颈动脉钙化不会增加溶栓诱导的sICH风险。颈动脉壁钙化程度较高的患者可能有较高的死亡率。
