Atherosclerosis cerebral artery

Ischemic stroke has numerous causes. Cerebral infarction may result from large artery atherosclerosis, cardiac embolism, small artery lipohyalinosis, cryptogenic embolism, or, more rarely, from other diverse conditions such as arterial dissection, infective endocarditis, and sickle cell disease. Arterial occlusion is the cause of at least 80% of acute cerebral infarctions. " ... 

Ischemic strokes account for 88% of all strokes and are due either to local thrombus formation or to emboli that occlude a cerebral artery. Cerebral atherosclerosis is a causative factor in most cases of ischemic stroke, although 30% are of unknown etiology. Emboli can arise either from intra- or extracranial arteries. Twenty percent of embolic strokes arise from the heart. 

Atherosclerosis in a cerebral artery can resnlt in an occlnsion, which could be caused by any of the mecha-... 

Familial dysbetalipoproteinemia (type III) is characterized by the accumulation of chylomicron and VLDL remnants, which are enriched in cholesterol compared to their precursors. The primary molecular cause of familial dysbetalipoproteinemia (type III) is the homozygous presence of the apolipoprotein E2 (apoE2) isoform, which is associated with recessive inheritance of the disorder [62]. However, only 1 in 50 homozygotes for apoE2 will develop type III hyperlipoproteinemia, which is clinically characterized by palmar and tuberous xanthomas, arcus lipoides, and premature atherosclerosis of coronary, peripheral, and cerebral arteries. Precipitating factors include diabetes mellitus, renal disease, hemochromatosis, but also familial hypercholesterolemia. In addition, some rare mutations in the apoE gene have been found to cause dominant and more penetrant forms of type III hyperlipoproteinemia. 

Kernan WN, Viscoli CM, Brass LM et al. (2000). The Stroke Prognosis Instrument II (SPIII) a clinical prediction instrument for patients with transient ischaemia and non-disabling ischaemic stroke. Stroke 31 456-462 Mathur KS, Kashyap SK, Kumar V (1963). Correlation of the extent and severity of atherosclerosis in the coronary and cerebral arteries. Circulation 27 929-934 Petty GW, Brown RD Jr., Whisnant JP et al. (2000). Ischemic stroke subtypes. 

Severity of atherosclerosis in cerebral arteries, coronary arteries, and aortas. 

The study of cerebrovascular disease has advanced markedly in recent years with advances in non-invasive imaging methods such as MR angiography and CT angiography as well as an improved understanding of the immune system in the pathogenesis of atherosclerosis. Atherosclerotic cerebrovascular disease is a common cause of strokes and shows a predilection for sites such as the bifurcation of the common carotid artery into the internal and external carotid arteries and the aortic arch and the major intracranial arteries such as the basilar artery and the middle cerebral arteries. Occlusive atherosclerotic vascular disease of these large extracranial arteries is responsible for as many as 20-30% of ischemic strokes and intracranial steno-occlusive disease causes around 5-10% of ischemic strokes. 

E., Romeny-Wachter, C. C. ter H., Woodford, T. H., and Gent, C. M. van Lipid and Fatty Acid Composition of Coronary and Cerebral Arteries at Different Stages of Atherosclerosis Lancet 1960-1 1162-1166 CA 55 5736i... 

Bamethane sulfate (V), a dilator drug known for many years, was recently employed in two studies involving patients with obliterative atherosclerosis and intermittent claudica-tion30/31. There was distinct clinical improvement in 7 patients. One patient, who failed to show improvement in lower limb circulation, nevertheless had some relief from the manifestations of concomitant cerebral arterial disease O. 

In addition to coronary sclerosis, evidence is accumulating that high Lp(a) levels may be important in the development of cerebrovascular and peripheral arterial disease, as well (J6, T8, U2). Lp(a) levels not only correlated well with clinical endpoints such as transient ischemic attack and cerebral infarction, but also were associated with the extent and severity of carotid atherosclerosis, as assessed by bidirectional Doppler ultrasound (K23, M33, Z2). 

Atherosclerosis is a condition of the organism characterized by elevated levels of atherogenic lipoproteins in blood plasma, lipid deposits (including cholesterol) in the form of esters inside walls of the arterial system, and it is expressed by a gradual difficulty of blood circulation. The most appropriate name for this disease is lipoproteinemia. Clinically, it is manifested in the form of ischemic heart disease, stroke, abnormal cerebral blood flow, and peripheral ischemia. 

Atherosclerosis is main cause of cardiovascular deaths. It is characterized by a localised plaque in the intima and is composed of cholesterol esters, deposition of fibrous proteins and calcification. These plaques may narrow the arterial lumen and can cause distalischemia. The coronary and cerebral circulation are main sites of atherosclerosis. Raised levels of VLDL, LDL... 

Lamy C, Giarmesini C, Zuber M et al. (2002). Clinical and imaging findings in cryptogenic stroke patients with and without patent foramen ovale the PFO-ASA Study (Atrial Septal Aneurysm). Stroke 33 706-711 Leung SY, Ng THK, Yuen ST et al. (1993). Pattern of cerebral atherosclerosis in Hong Kong Chinese severity in intracranial and extracranial vessels. Stroke 24 779-786 Leys D, Moulin Th, Stojkovic T et al. (1995). Follow-up of patients with history of cervical artery dissection. Cerebrovascular Diseases 5 43-49... 

Trials of the effects of endothelin receptor antagonists in patients with heart failure, coronary artery disease, arterial hjtpertension, and pulmonary hjtpertension have been reviewed (6), as have their uses in treating cancers (7) and cerebral vasospasm (8), and their potential uses in atherosclerosis, re-stenosis, myocarditis, shock, and portal hypertension (9)... 

Atherosclerosis involves the formation of lipid-rich plaques in the intima of arteries. The plaques begin as fatty streaks containing foam cells, which initially are macrophages filled with lipids, particularly cholesterol esters. These early lesions develop into fibrous plaques that may occlude an artery and cause a myocardial infarct or a cerebral infarct. Formation of these plaques is often associated with abnormalities in... 

Increased cholesterol is a factor in the cause of atherosclerotic diseases (see also Chapter 44). As early as 1910, Windaus described cholesterol in the lesions of diseased arteries. Subsequently, many studies have confirmed that free and esterified cholesterol accumulates in the aorta, coronary arteries, and cerebral vessels, and that the rate of accumulation varies among individuals. The association between serum cholesterol and atherosclerosis in humans was first suggested in 1938, when Muller and Thanhauser each demonstrated familial aggregation of hypercholesterolemia... 

Atherosclerosis is a chronic inflammation of the arterial vessel wall resulting in plaque formation that eventually may cause cardiovascular events, such as myocardial infarction or cerebral vascular accidents. The presence of autoimmune components in atherosclerosis is well established. Autoantibodies to heat-shock proteins and oxidized low-density lipoproteins (oxLDL) are prevalent in the circulation of patients with atherosclerosis, but the role of these autoantibodies is debated. While anti-oxLDL IgG antibodies may facilitate uptake of oxLDL by foam cells in the lesions, natural IgM antibodies directed to oxLDL may even protect from atherosclerosis. Atherosclerotic plaques also contain some T cells that are considered to be autoreactive, although the respective autoantigens have not yet been identified. These T cells are probably not involved in the plaque formation as such, but they may cause plaque instability, rupture, and subsequent clinical events. 

Hypertension and atherosclerosis are central to the pathogenesis of coronary artery disease (ischemia, angina, myocardial infarction) heart failure, cerebral (stroke) and peripheral vascular disease. 

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