Cerebral cortical microinfarcts in patients with internal carotid artery occlusion

Heart-Brain Connection Consortium

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Cerebral cortical microinfarcts (CMI) are small ischemic lesions that are associated with cognitive impairment and probably have multiple etiologies. Cerebral hypoperfusion has been proposed as a causal factor. We studied CMI in patients with internal carotid artery (ICA) occlusion, as a model for cerebral hemodynamic compromise. We included 95 patients with a complete ICA occlusion (age 66.2 ± 8.3, 22% female) and 125 reference participants (age 65.5 ± 7.4, 47% female). Participants underwent clinical, neuropsychological, and 3 T brain MRI assessment. CMI were more common in patients with an ICA occlusion (54%, median 2, range 1–33) than in the reference group (6%, median 0; range 1–7; OR 14.3; 95% CI 6.2–33.1; p<.001). CMI were more common ipsilateral to the occlusion than in the contralateral hemisphere (median 2 and 0 respectively; p<.001). In patients with CMI compared to patients without CMI, the number of additional occluded or stenosed cervical arteries was higher (p=.038), and cerebral blood flow was lower (B −6.2 ml/min/100 ml; 95% CI −12.0:–0.41; p=.036). In conclusion, CMI are common in patients with an ICA occlusion, particularly in the hemisphere of the occluded ICA. CMI burden was related to the severity of cervical arterial compromise, supporting a role of hemodynamics in CMI etiology.

Original languageEnglish
Pages (from-to)2690-2698
Number of pages9
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number10
Early online date25 Apr 2021
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation (CVON 2018-28 & 2012-06 Heart Brain Connection). GJB and HvdB acknowledge support by the Netherlands Organisation for Scientific Research (NWO) (Vici Grant 918.16.616). EEB acknowledges additional support from the Dutch Heart Foundation (PPP Allowance, 2018B011). Acknowledgements

Publisher Copyright:
© The Author(s) 2021.


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