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Atherosclerosis of precerebral arteries in cervical spondylotic myeloapthy

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KADAŇKA Zdeněk PEŠKA Stanislav JURA René BEDNAŘÍK Josef CHALOUPKA Richard

Rok publikování 2003
Druh Článek ve sborníku
Konference Proceedings symposium Chronobiological analysis in pathophysiology of cardiovascular system
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Obor Neurologie, neurochirurgie, neurovědy
Klíčová slova spondylotic myelopathy; cervical myelopathy; compressive myelopathy
Popis Study design. A prospective ultrasonographic study of precerebral arteries in a group of patients with cervical spondylotic myelopathy (CSM). Objectives: The aim of the study was to evaluate the prevalence of atherosclerotic changes in precerebral arteries in patients with CSM, in order to assess the degree of the vascular risk, a factor that can significantly influence the outcome of surgery or conservative treatment. Summary of background data. There are no available data dealing with the status of the precerebral arteries in patients with spondylotic cervical myelopathy. Methods. The studied group consisted of 62 consecutive patients with CSM resulting from spondylosis. Duplex ultrasonographic assessment of precerebral arteries (carotid and vertebral arteries) was performed using high-resolution duplex ultrasound equipment. Results. Thickening of the intimal or medial layers of the arterial wall was found in 20/62 (32.2%), stenosis of a. carotis <50% unilaterally or bilaterally in 7/62 (11.2%) and stenosis > 50% bilaterally in 2/62 (3.2%). In one case, vertebral arteries were not detected for anatomical reasons and in another one a signal was not obtainable from the right vertebral artery (aplasia? occlusion?), otherwise the findings were normal in this region. Conclusion. The distribution of atherosclerotic changes in the precerebral arteries of patients with CSM is similar to that in the general population and is increased in the presence of vascular risk factors. In spite of the low prevalence of significant stenotic changes in extracranial arteries, we suggest that ultrasonographic exploration should be made part of routine presurgical investigation in CSM, particularly in elderly patients with atherosclerotic risk factors in order to prevent unexpected cerebral events during surgery and in the postoperative period.
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