Clinical significance of carotid plaque hemorrhage
N. M. Bornstein, A. Krajewski, A. J. Lewis and J. W. Norris
Stroke Research Unit, Sunnybrook Health Science Centre, University of Toronto, Ontario.
We correlated the clinical and pathologic findings in 77 consecutive
carotid plaques removed at endarterectomy to determine the clinical role of
intraplaque hemorrhage. Intraplaque hemorrhages of various severity were
seen in 86% of plaques. They were, for the most part, deeply located (63%)
and infrequently connected with the lumen. They related closely to the
severity of carotid stenosis, but bore no relationship to the timing of
symptoms. Luminal thrombus was infrequently seen, and was always
microscopic. Hemorrhage into carotid plaque appears to represent an index
of the severity of the stenosis and plaque instability rather than to play
a direct role in the pathogenesis of transient ischemic attacks or stroke.
