Racial differences in the distribution of anterior circulation occlusive disease

We compared clinical and angiographic features of 26 white and 45 black patients with symptomatic occlusive cerebrovascular disease. White patients had more transient ischemic attacks, carotid bruits, and more severe occlusive disease of the internal carotid artery origin. Blacks had more severe disease of the middle cerebral artery stem and supraclinoid internal carotid arteries. Differences were not explained by racial differences in the prevalence of hypertension, diabetes, hypercholesterolemia, or ischemic heart disease. Since the middle cerebral artery lesions in blacks do not correlate with other accepted epidemiologic, clinical, and laboratory markers of atherosclerosis, the lesions may arise from a disorder that differs from atherosclerosis.

[1]  C. Fisher,et al.  Atherosclerosis of the Carotid and Vertebral Arteries—Extracranial and Intracranial , 1965 .

[2]  C. Derouesné,et al.  Ischemic accidents in the middle cerebral artery territory. A study of the causes in 122 cases. , 1968, Archives of neurology.

[3]  K. Amplatz,et al.  Racial differences in cerebrovascular disease. Angiographic evaluation of Japanese and American populations. , 1967, The American journal of roentgenology, radium therapy, and nuclear medicine.

[4]  C. Fisher,et al.  LATERAL MEDULLARY INFARCTION—THE PATTERN OF VASCULAR OCCLUSION , 1961, Journal of neuropathology and experimental neurology.

[5]  A. Baker,et al.  Cerebrovascular disease , 1959, Neurology.

[6]  S. Rostand,et al.  Racial differences in the incidence of treatment for end-stage renal disease. , 1982, The New England journal of medicine.

[7]  L. Caplan.  Vertebrobasilar disease. Time for a new strategy. , 1981, Stroke.

[8]  C. Fisher,et al.  Basilar artery branch occlusion , 1971, Neurology.

[9]  J. Popper,et al.  Factors Related to Stroke Incidence in Hawaii Japanese Men: The Honolulu Heart Study , 1980, Stroke.

[10]  L. Russo.  Carotid System Transient Ischemic Attacks: Clinical, Racial, and Angiographic Correlations , 1981, Stroke.

[11]  J. Whisnant,et al.  Occlusive vascular disease in the extracranial cerebral circulation. , 1960, Archives of neurology.

[12]  R. Loewenson,et al.  The geographic pathology of atherosclerosis: a review of the literature with some personal observations on cerebral atherosclerosis. , 1967 .

[13]  C. J. Schwartz,et al.  Atheroma of the Carotid and Vertebral Arterial Systems , 1961, British medical journal.

[14]  P. Yates,et al.  Carotico-vertebral stenosis. , 1957, Lancet.

[15]  G. Sypert,et al.  Cerebellar infarction. A clinicopathological study. , 1975, Archives of neurology.

[16]  J. Cornhill,et al.  Localization of atherosclerotic lesions in the human basilar artery. , 1980, Atherosclerosis.

[17]  George W. Williams,et al.  Vertebral Artery Stenosis: Long-Term Follow-Up , 1984, Stroke.

[18]  A. Heyman,et al.  Nonembolic Occlusion of the Middle Cerebral and Carotid Arteries – A Comparison of Predisposing Factors , 1970, Deutsches medizinisches Journal.

[19]  J. Meyer,et al.  An Arteriographic Study of Cerebrovascular Disease in Man: I. Stenosis and Occlusion of the Vertebral-Basilar Arterial System , 1960 .

[20]  T. Tomita,et al.  Cerebral Angiographic Study on C.V.D. in Japan , 1972, Angiology.

[21]  J. Resch,et al.  Autopsy Study of Cerebrovascular Disease in Japanese Men Who Lived in Hiroshima, Japan, and Honolulu, Hawaii , 1979, Stroke.

[22]  A. Callow,et al.  PATTERNS OF ATHEROSCLEROSIS OF EXTRACRANIAL CEREBRAL ARTERIES * , 1968, Annals of the New York Academy of Sciences.

[23]  T. Gordon.  Further mortality experience among Japanese Americans. , 1967, Public health reports.

[24]  M. Kameyama,et al.  Collateral circulation of the brain , 1963, Neurology.

[25]  J. Taveras,et al.  Incidence and significance of occlusive vascular disease of the extracranial arteries as demonstrated by post-mortem angiography. , 1961, Transactions of the American Neurological Association.

[26]  M. Fisher.  Occlusion of the carotid arteries: further experiences. , 1954, A.M.A. archives of neurology and psychiatry.

[27]  C. Fisher.  Bilateral occlusion of basilar artery branches. , 1977, Journal of neurology, neurosurgery, and psychiatry.

[28]  W. Mair,et al.  Atheromatous disease of the carotid arterial system and embolism from the heart in cerebral infarction: a morbid anatomical study. , 1969, Brain : a journal of neurology.

[29]  M. Gover,et al.  Negro mortality. IV. Urban and rural mortality from selected causes in the North and South. , 1951, Public health reports.

[30]  R. Brust.  Patterns of Cerebrovascular Disease in Japanese and Other Population Groups in Hawaii: An Angiographical Study , 1975, Stroke.

[31]  L. Mchenry,et al.  Cerebral Angiographic and Clinical Differences in Carotid System Transient Ischemic Attacks Between American Caucasian and Japanese Patients , 1984, Stroke.

[32]  L. Solberg,et al.  Cerebral atherosclerosis in Negroes and Caucasians. , 1972, Atherosclerosis.

[33]  T. Riles,et al.  Cervical vertebral angioplasty for brain stem ischemia. , 1981, Surgery.

[34]  A. Heyman,et al.  Joint study of extracranial arterial occlusion. VI. Racial differences in hospitalized patients with ischemic stroke. , 1972 .

[35]  R. Adams,et al.  Occlusion of the basilar artery; a clinical and pathological study. , 1946, Brain : a journal of neurology.

[36]  M. Alter,et al.  Cerebral infarction , 1972, Neurology.

[37]  L. Caplan.  Occlusion of the Vertebral or Basilar Artery: Follow Up Analysis of Some Patients with Benign Outcome , 1979, Stroke.

[38]  R. Ackerman,et al.  Symptomatic middle cerebral artery stenosis , 1979, Annals of neurology.

[39]  L. Mchenry,et al.  Carotid and vertebrobasilar transient ischemic attacks , 1979, Neurology.

[40]  S. Moore,et al.  Pathogenesis of atherosclerosis. , 1985, Metabolism: clinical and experimental.

[41]  J. Moossy.  Morphology, sites and epidemiology of cerebral atherosclerosis. , 1966, Research publications - Association for Research in Nervous and Mental Disease.

[42]  H. L. Bleich,et al.  The Harvard Cooperative Stroke Registry , 1978, Neurology.

[43]  J. Moossy.  Cerebral infarcts and the lesions of intracranial and extracranial atherosclerosis. , 1966, Archives of neurology.

[44]  C. Derouesné,et al.  Arterial occlusions in the vertebro-basilar system. A study of 44 patients with post-mortem data. , 1973, Brain : a journal of neurology.

[45]  W M STRAIGHT,et al.  Occlusion of the Internal Carotid Artery , 1961, Southern medical journal.

[46]  L. Caplan.  Bilateral distal vertebral artery occlusion , 1983, Neurology.

[47]  J. Meyer,et al.  Arteriographic study of sites, incidence, and treatment of arteriosclerotic cerebrovascular lesions , 1962, Neurology.