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London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 385 193 Vascular imaging Relationship of atherosclerotic plaque distribution and geometric characteristics in basilar ar-tery W.H. Jho1, H.Y. Kim2, Y.S. Kim3, Y.B. Lee4, H.S Kwon5 Department of Neurology, Hanyang University College of Medicine, Seoul, SOUTH KOREA1, Department of Neurology, Hanyang University College of Medicine, Seoul, SOUTH KOREA2, De-partment of Neurology, Hanyang University College of Medicine, Seoul, SOUTH KOREA3, Depart-ment of Neurology, Gachon University Gil Medical Center, Incheon, SOUTH KOREA4, Department of Neurology, Hanyang University College of Medicine, Seoul, SOUTH KOREA5 Background Atherosclerosis is the most common cause of ischemic stroke, but the intracranial atherosclerosis is not evaluated exactly because of the low quality of traditional magnetic resonance imaging (MRI). The vertebral artery (VA) and basilar artery (BA) have diverse geometric characteristics. In this study, we investigated the frequency and distribution of basilar plaque, and the relationship with geometric factors. Methods All persons who examined MR angiography (MRA) and high resolution MRI (HRMRI) from Sep-tember 2009 to April 2010 in a general tertiary referral hospital were enrolled. On MRA, geometric characteristics of BA and VA were evaluated. On HRMRI, plaques were divided by the involvement of anterior, posterior, right lateral and left lateral BA wall. The degree of stenosis of BA and the vol-ume of plaque were investigated. Results Total 1245 persons were enrolled. The prevalence rate of persons with basilar plaque was 7.87% (number=98). Plaque were more frequently involved the anterior (33.71%) and posterior (36.43%) wall than the right lateral (15.31%) or left lateral (17.63%) wall (p<0.001). Dominant VA was more frequent on the left side (Right VS Left, number; 37 VS 61). This VA dominant pattern was asso-ciated with the direction of BA curvature (p=0.03), but did not attributed to plaque distribution and characters. When BA curvature was dichotomized according to curvature angle degree on lateral view, low angle was more related to anterior wall distribution (p=0.043) of basilar plaque and high angle to posterior (p=0.048). Moreover, plaque burden is also associated with plaque distribution, and BA plaque with high burden was more prone to even distribution. Conclusions Basilar plaque frequently existed more than we expected and was more frequent at the anterior and posterior wall. BA curvature angle on lateral view might affect on this plaque distribution. More-over, the progression of atherosclerotic plaque may also influence on plaque distribution. 194 Vascular imaging CONTRIBUTION OF SPOT-SIGN IN THE DIAGNOSIS OF THE CENTRAL RETINAL ARTERY OCCLUSION O. Ayo-Martin1, E. Palazon-Garcia2, J. Garcia-Garcia3, T. Segura4 University Hospital of Albacete, Albacte, SPAIN1, University Hospital of Albacete, Albacte, SPAIN2, University Hospital of Albacete, Albacte, SPAIN3, University Hospital of Albacete, Albac-te, SPAIN4 Background, Central retinal artery occlusion (CRAO) is one of the most dramatic events that may be encountered in ophthalmological clinical practice. Most references in the literature consider in situ atheromato-sis as the main cause of CRAO, describing only 25 % of cases as embolic. The presence in orbital echography of a spot-sign (OSS, hyperechoic punctiform image) in the distal portion of the ACR is considered a valid marker of embolism. Objective To evaluate the presence of an orbital spot sign (OEE) in patients with recent diagnosis of CRAO and correlate this sign with the presence of embolic sources. Methods, Unicentric, prospectively and descriptive case study, along 2011, including all cases of acute CRAO (less than 7 days) diagnosed by clinical and ophthalmological evaluation including funduscopic ex-amination (FE). We performed in all patients a complete laboratory study and orbital, cervical and temporal echography, echocardiography and 24 hours-Holter-ECG . Results We studied 12 patients (7 male, mean age 72, 52-85). We found 11 (92%) embolic cases. The embolus was demonstrated by FE in 3 (27%) cases and by OSS in 9 (81%). Only in 1 patient embolus was observed in FE but not in ecography, but in this case embolus was located in a peripheric retinal branch of the ACR. Among the embolic CRAO cases, we found a cardioembolic source in 7(63%) cases: (2 atrial fi-brilation without anticoagulation, 2 metallic heart valve, 1 endocarditis, 1 patent oval foramen with septal aneurism, 1 ventricular hipocinesia) , a atheroembolic source in 1 (9%) case (ipsilateral carot-id atheromatosis with >50% stenosis), being the 3(27%) remaining cases of unknown origin . We found no case of giant cell arteritis. In the only case in our series in which the CRAO had no associated FE or ecographic image of em-bolism, the patient suffered from ipsilateral carotid occlusion. Conclusion In our series, and in contradiction to most ophthalmologic texts, CRAO etiology is mainly cardio-embolic. Ultrasound is much more sensitive than the funduscopic examination to detecting emboli in the ACR


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