Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Department of Radiodiagnostics, Invasive Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Medicina (Kaunas). 2021 Oct 15;57(10):1112. doi: 10.3390/medicina57101112.
: Carotid web (CaW) is an intimal variant of fibromuscular dysplasia and may constitute as one of rare causes of acute ischemic stroke (AIS). The objective of this study was to determine the prevalence of CaW in patients with AIS or transient ischemic attack (TIA) based on head/neck CT angiography (CTA) in a Polish cohort study. : A retrospective study was performed by analyzing 1480 electronic clinical and imaging data regarding patients with AIS or TIA, hospitalized in the years 2018-2020 in the authors' institution. The final sample consisted of 181 patients who underwent head/neck CTA; aged 67.81 ± 13.51 years (52% were women). All head/neck CTA studies were independently evaluated by two radiologists. The patient's clinical condition was assessed with the National Institutes of Health Stroke Scale (NIHSS, 5.76 ± 4.05 and 2.88 ± 3.38 at admission and at discharge, respectively). : 27 patients were identified with CaW. The prevalence of CaW in the final sample (181 pts with good quality CTA) was 14.9%. In the CaW group, 89% patients had AIS, including 26% diagnosed with recurrent and 11% with cryptogenic strokes. There were no significant differences between the presence of CaW and gender, age, NIHSS score, recurrent or cryptogenic stroke. Our study demonstrated that CaW may be an underrecognized entity leading to cerebrovascular events. The diagnosis of CaW depends on a high level of awareness and a comprehensive analysis of the neuroimaging studies. Our findings support the hypothesis that it is worthwhile to perform CTA to determine the etiology of ischemic stroke, particularly if predicting factors were not identified.
颈动脉壁（CaW）是一种纤维肌发育不良的内膜变异，可能是急性缺血性卒中（AIS）的罕见原因之一。本研究的目的是通过波兰队列研究中的头颈部 CT 血管造影（CTA）确定 AIS 或短暂性脑缺血发作（TIA）患者中 CaW 的患病率。
这是一项回顾性研究，通过分析作者机构 2018 年至 2020 年期间收治的 181 名 AIS 或 TIA 患者的 1480 份电子临床和影像资料进行。所有头颈部 CTA 研究均由两名放射科医生独立评估。患者的临床状况通过美国国立卫生研究院卒中量表（NIHSS）进行评估（入院时为 5.76 ± 4.05，出院时为 2.88 ± 3.38）。
研究共发现 27 例 CaW 患者。最终样本（181 例 CTA 质量良好的患者）中 CaW 的患病率为 14.9%。在 CaW 组中，89%的患者患有 AIS，包括 26%诊断为复发性卒中，11%为隐源性卒中。CaW 的存在与性别、年龄、NIHSS 评分、复发性或隐源性卒中之间无显著差异。
本研究表明，CaW 可能是导致脑血管事件的一种未被充分认识的实体。CaW 的诊断取决于对神经影像学研究的高度认识和全面分析。我们的研究结果支持这样一种假设，即进行 CTA 以确定缺血性卒中的病因是值得的，特别是如果没有确定预测因素。
