High-grade internal carotid artery stenosis and chronic brain damage: a volumetric magnetic resonance imaging study.

BACKGROUND

Experimental data suggest that high-grade vascular stenosis may induce chronic cerebral tissue damage.

METHODS

We tested this hypothesis in 97 patients with a ≥70% unilateral internal carotid artery (ICA) stenosis (mean age: 69.1 ± 10.2 years), comparing intraindividual side-to-side differences in hemispheric brain and white matter hyperintensity (WMH) volumes. Patients with a supratentorial infarct exceeding 1.5 cm in diameter were excluded.

RESULTS

Overall, the median WMH volume was greater in the hemisphere ipsilateral to the stenotic ICA (1.13 ± 2.65 vs. 0.77 ± 2.26 cm³; p = 0.005), but there were no differences in hemispheric brain volumes between the stenotic and nonstenotic sides. In the subgroup of patients with moderate and severe WMH (n = 41), the hemispheric volume ipsilateral to the stenotic ICA was significantly smaller (543.46 ± 22.17 vs. 548.66 ± 26.7 cm³; p = 0.03). Multivariate linear regression analysis revealed an independent effect of WMH grade on interhemispheric volume differences relative to the side of stenosis.

CONCLUSIONS

Chronic tissue damage may occur in a subset of individuals with ≥70% ICA stenosis, globally exhibiting more extensive WMH.