{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:08:07Z","timestamp":1753891687455,"version":"3.41.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Although carotid artery intraplaque hemorrhage (IPH) is a known risk-factor for cerebral ischemic events in patients of advanced age, its prevalence in younger cohorts is less certain. The purpose of this study was to assess the prevalence of carotid artery IPH across the age spectrum. A retrospective review was completed of all adult patients from our institution who underwent neck MRA with high-resolution carotid plaque imaging between 2017 and 2020. The mean ages of patients with and without IPH were calculated. The prevalence of IPH was compared between patients that were categorized into age groups. Patients with and without a cerebral ischemic event (e.g., stroke, retinal ischemia) were included. Unilateral anterior circulation ischemic events in patients without atrial fibrillation were presumed to be likely related to ipsilateral carotid artery disease. Multiple regression analysis was performed to determine independent associations with IPH. 634 patients were included (1,268 carotid arteries). Increasing age (OR: 1.04; 95% CI: 1.02\u20131.06; <jats:italic>P<\/jats:italic> = 0.001) was independently associated with IPH. 211 patients had unilateral anterior circulation ischemic events. The mean age of patients with carotid IPH was 71.4 years (SD = 9.9), compared to 62.8 years (SD = 15.8) of those without (<jats:italic>P<\/jats:italic> \u2264 0.0001). The prevalence of IPH increased with age in all patients (<jats:italic>P<\/jats:italic> = 0.0002). Among patients with ipsilateral anterior circulation ischemic events, each age category above 50 years had a significantly higher prevalence of IPH when compared to patients 18\u201350 years (<jats:italic>P<\/jats:italic> \u2264 0.05 for all comparisons). The prevalence of carotid IPH increases with age and is rare in patients under 50 years. The approximate threshold age for IPH development is likely around 50 years.<\/jats:p>","DOI":"10.3389\/fneur.2020.603055","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T06:43:37Z","timestamp":1607928217000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Variations in the Presence of Carotid Intraplaque Hemorrhage Across Age Categories: What Age Groups Are Most Likely to Benefit From Plaque Imaging?"],"prefix":"10.3389","volume":"11","author":[{"given":"Anthony S.","family":"Larson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Benson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Savastano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"John","family":"Huston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deena","family":"Nasr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1161\/01.str.21.1.148","article-title":"Carotid plaque morphology and risk for stroke","volume":"21","author":"Gomez","year":"1990","journal-title":"Stroke"},{"key":"B2","doi-asserted-by":"publisher","first-page":"E9","DOI":"10.3174\/ajnr.A5488","article-title":"Carotid artery wall imaging: perspective and guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology","volume":"39","author":"Saba","year":"2018","journal-title":"AJNR Am J Neuroradiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.jcmg.2019.03.028","article-title":"Prediction of stroke risk by detection of hemorrhage in carotid plaques: meta-analysis of individual patient data","volume":"13","author":"Schindler","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"B4","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1148\/radiol.2522080792","article-title":"Moderate carotid artery stenosis: MR imaging-depicted intraplaque hemorrhage predicts risk of cerebrovascular ischemic events in asymptomatic men","volume":"252","author":"Singh","year":"2009","journal-title":"Radiology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.jvs.2007.09.064","article-title":"Detection of intraplaque hemorrhage by magnetic resonance imaging in symptomatic patients with mild to moderate carotid stenosis predicts recurrent neurological events","volume":"47","author":"Altaf","year":"2008","journal-title":"J Vasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1212\/WNL.0b013e318287281b","article-title":"CHADS(2), CHA(2)S(2)DS(2)-VASc, and long-term stroke outcome in patients without atrial fibrillation","volume":"80","author":"Ntaios","year":"2013","journal-title":"Neurology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1161\/01.str.28.9.1693","article-title":"Does the association of risk factors and atherosclerosis change with age? An analysis of the combined ARIC and CHS cohorts. The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health Study (CHS) investigators","volume":"28","author":"Howard","year":"1997","journal-title":"Stroke"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1161\/STROKEAHA.108.529883","article-title":"Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry","volume":"40","author":"Putaala","year":"2009","journal-title":"Stroke"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1002\/jmri.25984","article-title":"Diagnostic accuracy of a clinical carotid plaque MR protocol using a neurovascular coil compared to a surface coil protocol","volume":"48","author":"Brinjikji","year":"2018","journal-title":"J Magn Reson Imaging"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.mri.2008.05.002","article-title":"An optimized 3D inversion recovery prepared fast spoiled gradient recalled sequence for carotid plaque hemorrhage imaging at 3.0 T","volume":"26","author":"Zhu","year":"2008","journal-title":"Magn Reson Imaging"},{"key":"B11","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1056\/NEJM199108153250701","article-title":"Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis","volume":"325","author":"Barnett","year":"1991","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1161\/STROKEAHA.117.017877","article-title":"Age-specific sex differences in magnetic resonance imaging-depicted carotid intraplaque hemorrhage","volume":"48","author":"Singh","year":"2017","journal-title":"Stroke"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.3174\/ajnr.A4414","article-title":"Intraplaque hemorrhage and the plaque surface in carotid atherosclerosis: the plaque at RISK study (PARISK)","volume":"36","author":"van Dijk","year":"2015","journal-title":"AJNR Am J Neuroradiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1002\/ana.23876","article-title":"Carotid plaque hemorrhage on magnetic resonance imaging strongly predicts recurrent ischemia and stroke","volume":"73","author":"Hosseini","year":"2013","journal-title":"Ann Neurol"},{"key":"B15","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.hlc.2013.03.001","article-title":"Pathophysiology of atherosclerosis plaque progression","volume":"22","author":"Sakakura","year":"2013","journal-title":"Heart Lung Circ"},{"key":"B16","doi-asserted-by":"publisher","first-page":"3007","DOI":"10.1161\/01.atv.19.12.3007","article-title":"Age and sex differences in the distribution and ultrasound morphology of carotid atherosclerosis: the Tromso Study","volume":"19","author":"Joakimsen","year":"1999","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1016\/S1474-4422(18)30233-3","article-title":"Epidemiology, aetiology, and management of ischaemic stroke in young adults","volume":"17","author":"Ekker","year":"2018","journal-title":"Lancet Neurol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1177\/2396987318755585","article-title":"Frequency and features of embolic stroke of undetermined source in young adults","volume":"3","author":"Perera","year":"2018","journal-title":"Eur Stroke J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1161\/STROKEAHA.116.016414","article-title":"embolic stroke of undetermined source: a systematic review and clinical update","volume":"48","author":"Hart","year":"2017","journal-title":"Stroke"},{"key":"B20","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1212\/WNL.0000000000002978","article-title":"Nonstenotic carotid plaque on CT angiography in patients with cryptogenic stroke","volume":"87","author":"Coutinho","year":"2016","journal-title":"Neurology"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1956","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.02.042","article-title":"Carotid Intraplaque hemorrhage in patients with embolic stroke of undetermined source","volume":"27","author":"Singh","year":"2018","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"B22","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1161\/STROKEAHA.114.006286","article-title":"Intraluminal thrombus, intraplaque hemorrhage, plaque thickness, and current smoking optimally predict carotid stroke","volume":"46","author":"McNally","year":"2015","journal-title":"Stroke"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2020.603055\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T06:43:38Z","timestamp":1607928218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2020.603055\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,14]]},"references-count":22,"alternative-id":["10.3389\/fneur.2020.603055"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2020.603055","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2020,12,14]]},"article-number":"603055"}}