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Original Paper

Hyperechoic Plaque: An Ultrasound Marker for Osteoporosis in Acute Stroke Patients with Carotid Disease

Saverino A.c · Del Sette M.a · Conti M.a · Ermirio D.d · Ricca M.a · Rovetta G.b · Gandolfo C.a

Author affiliations

aDepartment of Neuroscience, Ophthalmology and Genetics, and bBruzzone Institute of Rheumatology, University of Genova, cSalvatore Maugeri Foundation and dDepartment of Vascular Surgery, Sampierdarena Hospital, Genova, Italy

Related Articles for ""

Eur Neurol 2006;55:31–36

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 06, 2005
Accepted: November 29, 2005
Published online: March 01, 2006
Issue release date: February 2006

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 3

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: http://www.karger.com/ENE

Abstract

Background: Osteoporosis is a significant complication of stroke, and hip fracture after a stroke is a frequent problem. Moreover, growing evidence links vascular and bone diseases, in the form of osteoporosis associated with both atherosclerosis and vascular calcification. The aim of our study is to detect bone change in the acute phase of ischemic stroke in patients with carotid disease and to verify the correlation with carotid echogenic plaques. Patients and Method: Out of 245 subjects consecutively admitted to our Stroke Unit for their first ischemic stroke, we selected 49 patients with a first-ever stroke due to carotid atherosclerosis without a previous diagnosis of bone disease. We assessed risk factors for cerebrovascular disease as well as for osteoporosis, the degree of neurological deficit and disability, and bone mineral density that was quantified by bilateral hip dual energy X-ray absorbimetry. Osteoporosis was defined as a T score below –2.5. Carotid ultrasound was used to classify plaques in non-hyperechoic (grade 1) and hyperechoic plaque (grade 2). Results: We found a high prevalence of low bone mass density (BMD) in our patients (18 out of 49 = 36.7%), without relationship to the side of paresis. According to univariate analysis evidence of osteoporosis was correlated with age (p = 0.05), score of Scandinavian Stroke Scale (p = 0.01) and grade 2 plaque (p = 0.01). According to multivariate analysis, there was a significant positive correlation between grade 2 plaques and osteoporosis (OR = 6.58; 95% CI = 1.57–27.54; p = 0.01), which was stronger in women (OR = 18.15; 95% CI = 1.80–182.83; p = 0.01). The percentage of intraplaque hyperechogenicity was inversely correlated with BMD (r = –0.411, p = 0.016). Conclusion: Osteoporosis is highly prevalent in acute atherosclerotic stroke patients. Carotid hyperechoic plaque is an independent marker of osteoporosis.

© 2006 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 06, 2005
Accepted: November 29, 2005
Published online: March 01, 2006
Issue release date: February 2006

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 3

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: http://www.karger.com/ENE


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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