Frequency and clinical correlates of occlusive lesions of cerebral arteries in Japanese patients without stroke. Evaluation by MR angiography.

To determine the frequency and clinical correlates of intra- and extracranial arterial occlusive lesions in a stroke-free population, we studied cerebral arteries in 156 subjects with no evidence of stroke who presented at a neurologic clinic with concerns about a possible stroke (104 males ranging in age from 37 to 83 years, with a mean age of 63.0) by using MR angiographies (MRAs). According to a validated rating scheme of MRAs for occlusive lesions, the degree of stenoses in the cervical portion of the carotid artery and of the intracranial arteries including the intracranial portion of the internal carotid artery, the middle cerebral artery stem, and the basilar artery were evaluated. Stenoses (>25% narrowing in diameter) were found in 18 patients (11.5%) in the cervical carotid artery, and in 23 patients (14.7%) in the intracranial arteries. Multiple logistic regression analysis showed that age and hyperlipidemia were significant and independent predictors for cervical carotid artery stenoses, and that age and hypertension were predictors for intracranial artery stenoses. Our data based on this special cohort of stroke-free patients suggested that the risk factors for extra- and intracranial artery lesions were different, and that MRA is possibly efficient in those patients in whom cerebral artery occlusive lesions may be suspected. e.g. in hyperlipidemic or hypertensive elderly. Larger population-based studies are needed to confirm these results.