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Ulcerated plaques were present in 26 percent of the 239 patients with cerebrovascular disease but in only 5 percent of the 261 patients with other neurologic diseases(P<0.001).After we controlled for age and heart weight,the adjusted rates were 16.9 percent and 5.1 percent respectively (adjusted odds ration 4.0;95 percent confidence interval,2.1 to 7.8;P<0. 001).Among the patients with cerebrovascular disease,the prevalence of ulcerated plaques in the aortic arch was 28 percent in the 183 patients with cerebral infarcts and 20 percent in the 56 patients with brain hemorrhage.The prevalence of ulcerated plaques was 61 percent among the 28 patients with no known cause of cerebral infarction(P<0.001).After adjustment for covariates,the prevalence was 57.8 percent among patients with no known cause of cerebral infarction and 20.2 percent among those with a known cause(adjusted odds ration,5.7;95 percent confidence interval,2.4 to 13.6;P<0.001).The presence of ulcerated plaques in the aortic arch was not correlated with the presence of extracranial internal- carotid-artery stenosis,suggesting that these were two independent risk factors for stroke.Ulcerated plaques in the aortic arch may play a part in causing cerebral infarction,especially in patients whom cerebral infarction has no known cause. |
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