Association between White Matter Ischemia (WMI) and Carotid Plaque Morphology

In a recent study by Patterson AJ, etal. the above relationship was evaluated. Carotid Plaque morphology as evaluated with High resolution in vivo MRI shows that certain plaque characteristics such as- thin or ruptured fibrous caps, large necrotic lipid core or intraplaque hemorrhage may be associated with thromboembolic Stroke. The question they had was if WMI is related to plaque morphology. They found no relationship.

In my opinion, this points out that the possible mechanism of white matter ischemia is not thromboembolic but possibly atherosclerotic. White matter ischemia may be seen in patients with Dementia. Although Carotid  MRI might be useful as a predictor of thromboembolic stroke, it doesn’t seem to be useful in the evaluation of Dementia. Here is the citation:

Patterson AJ, etal. Association between white matter ischemia and carotid plaque morphology as defined by high resolution in vivo  MRI, Eur J Vasc Endovasc Surg (2009) 38, 149-154.

Adolfo Cotter, MD

Feb 25/2010

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