Atherosclerotic Changes of the Aortic Arch in Patients with Lacunar Infarction and Their Clinical Significance

J Korean Neurol Assoc > Volume 14(2); 1996 > Article

Journal of the Korean Neurological Association 1996;14(2): 331-338.

소공뇌경색증 환자에서 대동맥궁의 죽상경화성 변화와 임상적 의의

신상훈, 김대성, 박진운, 박재현, 김병옥*, 이건주*

인제대학교 의과대학 상계백병원 신경과학교실, 내과학교실*

Atherosclerotic Changes of the Aortic Arch in Patients with Lacunar Infarction and Their Clinical Significance

Sang Hoon Shin, M.D., Jae Hyeon Park, M.D., Dae Sung Kim, M.D., Jin Woon Park, M. D., Byung Ohk Kim, M.D.*, Gun Ju Rhi, M.D.*

Department of Neurology and Internal Medicine, College of Medicine, Inje University, Sanggye Paik Hospital

Abstract

It is well known recently that atherosclerotic changes of the aortic arch may play a role as an embolic source in development of cerebral infarction. But there are few reports that atherosclerotic changes of the aortic arch is one of the risk factors in lacunar infarction. Therefore, we studied clinical significance of atherosclerotic changes of the aortic arch as an independent risk factor of embolic sources in lacunar infarction. We studied 36 patients with lacunar infarction using transesophageal echocardiography to detect athersclerotic lesion of the aortic arch for embolism and simultaneuosly evaluated carotid vascular diseases by means of carotid doppler. We also examined other traditional risk factors for lacunar infarction in these patients. Eight patients had atherosclerotic lesions of the aortic arch on transesophageal echocardiography and there were atherosclerotic plaques or atheromas on ascending aorta in six patients and on descending aorta in two patients. Among the eight patients with atherosclerotic lesions of the aortic arch, four patients had atherosclerotic lesions in carotid arteries and also other risk factors for lacunar infarction. The other four patients had neither abnormal carotid doppler findings nor other traditional risk factors for cerebral infarction. Thus we concluded that atherosclerotic lesions of the aortic arch may play a role in developing lacunar infarction as an independent risk factor, especially in these patients who do not have known risk factors for cerebral infarction except atherosclerotic lesions of the ascending aorta.