Clinical Significance of Carotid Plaque Using Ultrasonography in Patients with Cerebral Thrombosis.

To clarify the significance of carotid plaques, 98 patients with cerebral thrombosis were studied to examine the infarcted area on computerized tomography (CT) and arteriosclerosis of the peripheral arteries. According to the ultrasonographic findings, the plaques were classified into three types: nodular, homogeneous mural, and mixed plaques. Arteriosclerosis of the limbs was estimated by determination of the ankle pressure index (API) and a low API (less than 0.9) was considered to indicate stenotic lesions of the peripheral arteries. The mean age was 73.3 years in 47 men and 78.1 years in 51 women. CT revealed lacunar infarction in 42, cortical infarction in 38, Binswanger type infarction in 9, and brain stem infarction in 9 cases. Compared to 40 age-matched controls, who had normal findings on CT and API, the incidence of carotid lesions was significantly higher in patients with cerebral thrombosis than that of the controls, especially in patients with Binswanger-type infarction. In 61 cases, there were 108 plaques, consisting of 54 nodular plaques, 41 homogeneous mural plaques, and 13 mixed plaques. Both homogeneous mural and mixed plaques were larger than the nodular plaques, though most plaques were seen in the carotid bifurcation. There was no significant correlation between the infarcted areas and plaque type. Cases of nodular plaque had an API similar to that of patients without plaques (1.00±0.16) . In contrast, homogeneous mural and mixed plaques showed low API values (0.80±0.20 and 0.74±0.23, respectively) . These findings suggest that carotid lesions were not only significantly associated with cerebral thrombosis, but both homogeneous mural and mixed plaques indicate the development of arteriosclerosis.