2, 5Although intracranial large artery occlusive disease is a considerably less common cause of artery-to-artery embolism than extracranial disease in the Caucasian population, the absence of a defined embolic source in the extracranial vessels or the heart should prompt evaluation of the intracranial vessels. 2 This increases to approximately 30% in the posterior circulation (vertebro-basilar/posterior cerebral arteries). Approximately 5-8% of clinically relevant large artery disease in the anterior circulation (carotid, middle cerebral and anterior cerebral arteries) is located intracranially. In up to 66% of these patients the likely embolic source is atheromatous disease of the extracranial or intracranial carotid arteries, vertebral arteries, basilar artery or middle cerebral arteries. 3, 4 These occlusions are most commonly caused by emboli and suggest one or more sources in a proximal large artery, the aorta or the heart. 2 Angiographic and sonographic imaging of intracranial vessels within six hours of the onset of an ischaemic stroke shows large artery occlusion in up to 70% of patients. The most common cause is occlusion of a large artery, resulting from or associated with thrombosis and/or artery-to-artery embolism. 1 Stroke is a heterogeneous disorder with many clinical manifestations and aetiologies. Every year approximately 40 000 Australians have a stroke and by 2020 the number of cases is expected to rise by 60%.
0 kommentar(er)
