London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 393 207 Vascular imaging Relationship of Brachial-ankle Pulse Wave Velocity and Intracranial Cerebral Artery Calcifi-cation in Patients with Acute Ischemic Stroke B.G. Yoo1, J.H. Lee2, K.J. Kim3, M.K. Kim4, S.H. Choi5 Department of Neurology, Kosin University College of Medicine, Busan, SOUTH KOREA1, Department of Neurology, Kosin University College of Medicine, Busan, SOUTH KOREA2, De-partment of Neurology, Kosin University College of Medicine, Busan, SOUTH KOREA3, Depart-ment of Neurology, Kosin University College of Medicine, Busan, SOUTH KOREA4, Department of Neurology, Dongkang Hospital, Ulsan, SOUTH KOREA5 Background: Brachial-ankle pulse wave velocity (BaPWV) is representative and simple methods for evaluating arterial stiffness. The aim of the present study was to elucidate the relationship between intracranial cerebral arterial calcification and BaPWV in patients with acute ischemic stroke. Meth-ods: A total of 88 patients with acute cerebral infarction who had undergone computed tomography angiography (CTA) and BaPWV measurement between March 2010 and July 2012 were enrolled. The BaPWV was divided to tertile. The degree of calcification in the intracranial internal carotid artery (ICA), vertebral artery (VA), anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral arery (PCA), and basilar artery (BA) was determined using the specific parame-ters. Results: Patients with higher BaPWV tended to have a higher arterial calcification score, older age, higher blood pressure, higher pulse pressure, higher heart rate, lower hemoglobin, higher eryth-rocyte sedimentation rate, lower glomerular filtration rate, and higher pro-brain natriuretic peptide level (P<0.05). Intracranial ICA and VA were related with arterial stiffness (P<0.01), but MCA, ACA, PCA and BA were not. Multiple regression analysis revealed that BaPWV was related to total calcification score and systolic blood pressure (P<0.05). Conclusion: Increased BaPWV is associat-ed with intracranial cerebral arterial calcification and systolic blood pressure in patients with acute ischemic stroke. Our study suggests that the severity of calcification in the intracranial ICA and VA is representative of the degree of systemic arterial stiffness. 208 Vascular imaging Neuroradiological Aspects of Fibrocartilagenous Emboli. K. Yoshikawa1, M. Tanaka2, S. Sugiura3, Y. Shimizu4, T. Takahashi5, T. Ito6, R. Fukunaga7, A. Ni-shi8, N. Yamamoto9, Y. Honda10, K. Hayasaki11, K. Morikawa12 Department of Neurology, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JAPAN1, Department of Strokology, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JAPAN2, De-partment of Neuroendovascular therapy, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osa-ka, JAPAN3, Department of Strokology, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JAPAN4, Department of Strokology, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JAPAN5, Department of Rehabilitation, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JAPAN6, Department of Strokology, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JA-PAN7, Department of Neurosurgery, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JA-PAN8, Department of Neurosurgery, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JA-PAN9, Department of Neurosurgery, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osaka, JAPAN10, Department of Neuroendovascular therapy, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osa-ka, JAPAN11, Department of Neurosurgery, Stroke Center, Hoshigaoka Koseinenkin Hospital, Osa-ka, JAPAN12 <Background> A fibrocartilagenous embolism (FCE) is a rare cause of ischemia of the central ner-vous system (CNS) resulting from migrated nucleus pulposus material into the vascular circulation. Most of the previously reported cases were confirmed by autopsy. However, recent progress enables us to diagnose FCE without biopsy, and antemortem diagnostic criteria have been proposed (Mateen et al. 2011).<Methods> We retrospectively reviewed the patients with acute spinal cord and cerebral infarction admitted to our stroke unit from September 2010 to December 2012 to find the cases that matches Mateen’s criteria. <Results> In 929 patients admitted to the stroke unit, we found four cas-es with spinal infarction, and one met the criteria. The case was a 57-year-old female who suddenly suffered from acute pain in her lower extremities followed by severe paraparesis with anesthesia and disuria. She had undergone chiropractic manipulation of her lumbar spine twelve hours before the onset. She had no vascular risk factors. Right-to-left shunts, including a patent foramen ovale, were not found by ultrasound. T2- and diffusion weighted images (DWI) showed hyperintensity of her lumbar cord at the level of the twelfth thoracic vertebra. Schmorl’s nodules (SN) were found in the eighth and ninth thoracic vertebrae with abnormal leakage of contrast media on Gd-enhanced T1-weighted images (Gd-T1), which strongly suggested the acute disruption of the cartilage end-plate zone. We concluded that the spinal lesion was a FCE, and immediate antithrombotic and high-dose corticosteroid treatment successfully eliminated her paraparesis. <Conclusion> MRI findings of vertebrae and intervertebral disks were not considered to be important in Mateen’s criteria. How-ever, DWI of the spinal cord together with Gd-T1 of the adjacent vertebrae might be crucial for the urgent diagnosis of FCE, and may contribute to an earlier initiation of therapy.
Karger_ESC London_2013
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