It is well known recently that atherosclerotic changes of the aortic arch may play a role as an embolic source in development of cerebral infarction. But there are few reports that atherosclerotic changes of the aortic arch is one of the risk factors in lacunar infarction. Therefore, we studied clinical significance of atherosclerotic changes of the aortic arch as an independent risk factor of embolic sources in lacunar infarction. We studied 36 patients with lacunar infarction using transesophageal echocardiography to detect athersclerotic lesion of the aortic arch for embolism and simultaneuosly evaluated carotid vascular diseases by means of carotid doppler. We also examined other traditional risk factors for lacunar infarction in these patients. Eight patients had atherosclerotic lesions of the aortic arch on transesophageal echocardiography and there were atherosclerotic plaques or atheromas on ascending aorta in six patients and on descending aorta in two patients. Among the eight patients with atherosclerotic lesions of the aortic arch, four patients had atherosclerotic lesions in carotid arteries and also other risk factors for lacunar infarction. The other four patients had neither abnormal carotid doppler findings nor other traditional risk factors for cerebral infarction. Thus we concluded that atherosclerotic lesions of the aortic arch may play a role in developing lacunar infarction as an independent risk factor, especially in these patients who do not have known risk factors for cerebral infarction except atherosclerotic lesions of the ascending aorta.
Aorta ; Aorta, Thoracic* ; Carotid Arteries ; Cerebral Infarction ; Echocardiography, Transesophageal ; Embolism ; Humans ; Plaque, Atherosclerotic ; Risk Factors ; Stroke, Lacunar* ; Vascular Diseases