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PT  - JOURNAL ARTICLE
AU  - Larson, A.S.
AU  - Brinjikji, W.
AU  - Lekah, A.
AU  - Klaas, J.P.
AU  - Lanzino, G.
AU  - Huston, J.
AU  - Saba, L.
AU  - Benson, J.C.
TI  - Nonstenotic Carotid Plaques and Embolic Stroke of Undetermined Source: A Multimodality Review
AID  - 10.3174/ajnr.A7750
DP  - 2023 Feb 01
TA  - American Journal of Neuroradiology
PG  - 118--124
VI  - 44
IP  - 2
4099  - http://www.ajnr.org/content/44/2/118.short
4100  - http://www.ajnr.org/content/44/2/118.full
SO  - Am. J. Neuroradiol.2023 Feb 01; 44
AB  - Symptomatic nonstenotic carotid artery disease has been increasingly recognized as a thromboembolic source in patients who would otherwise be classified as having embolic stroke of undetermined source. Evidence suggests that certain plaque features seen on sonography, CT, and MR imaging in nonstenotic carotid artery disease may predispose to recurrent stroke in patients with embolic stroke of undetermined source. We performed a focused literature review to further study plaque features in the context of embolic stroke of undetermined source and to determine which plaque features may be associated with ipsilateral ischemic events in such patients. Plaque thickness as seen on both ultrasound and CT appears to have a consistent association with ipsilateral stroke in patients with embolic stroke of undetermined source across multiple studies. Intraplaque hemorrhage as seen on MR imaging is now understood to have a strong association with ipsilateral stroke in patients with embolic stroke of undetermined source. Continued study of various plaque features as seen on different modalities is warranted to uncover other potential associations.ESUSembolic stroke of undetermined sourceIPHintraplaque hemorrhageLRNClipid-rich necrotic coreSyNCsymptomatic nonstenotic carotid artery diseaseUSultrasound