Brain imaging findings downstream of carotid artery disease, such as silent infarctions and white matter hyperintensities, are strongly associated with future stroke and cognitive impairment.
What are the downstream brain imaging biomarkers associated with carotid artery atherosclerotic disease?
Downstream brain imaging findings such as white matter hyperintensities and silent infarctions may serve as powerful biomarkers of cerebrovascular health in patients with carotid artery disease.
Extracranial carotid artery atherosclerotic disease is a major contributor to ischemic stroke. Carotid atherosclerotic disease can present with a spectrum of findings ranging from mild carotid intima-media thickness to high-risk vulnerable carotid plaque features and carotid stenosis. Before leading to clinically overt stroke or transient ischemic attack, there may be other markers of downstream ischemia secondary to carotid atherosclerotic disease. In this review article, we will review some of the imaging findings that may be seen downstream to carotid artery disease on various imaging modalities, including hemodynamic and perfusional abnormalities which may be seen on CT, MR, or using other advanced imaging techniques, white matter hyperintensities on brain imaging, silent or covert brain infarctions, cerebral microbleeds, and regional and generalized cerebral volume loss. Many of these imaging findings are seen routinely on brain magnetic resonance imaging in patients without overt clinical symptoms. Despite frequently being asymptomatic, many of these imaging findings are also strongly associated with increased risk of future stroke, cognitive impairment, and even mortality. We will review the existing evidence underpinning the associations between these frequently encountered imaging findings and carotid artery atherosclerotic disease. Future validation of these imaging findings could lead to them being powerful biomarkers of cerebrovascular health.
Baradaran et al. (Thu,) conducted a review in Carotid artery disease. Brain imaging biomarkers was evaluated. Brain imaging findings downstream of carotid artery disease, such as silent infarctions and white matter hyperintensities, are strongly associated with future stroke and cognitive impairment.