Published Online
on June 16, 2003

A more recent version of this article appeared on July 1, 2003

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Submitted on October 9, 2002
Revised on November 12, 2002

Is There a Side Predilection for Cerebrovascular Disease?

Sergio A. Rodríguez Hernández; Abraham A. Kroon; Martin P.J. van Boxtel; Werner H. Mess; Jan Lodder; Jelle Jolles; and Peter W. de Leeuw^*

From the Departments of Internal Medicine (S.A.R.H., A.A.K., P.W.d.L.), Clinical Neurophysiology (W.H.M.), and Neurology (J.L.), University Hospital Maastricht, The Netherlands; the Department of Psychiatry and Neuropsychology, Maastricht University (S.A.R.H., M.P.J.v.B., J.J.); European Graduate School of Neuroscience (EURON) (M.P.J.v.B., J.J.); and Cardiovascular Research Institute Maastricht (CARIM) (S.A.R.H., A.A.K., W.H.M., J.L., P.W.d.L.).

^* To whom correspondence should be addressed. E-mail: P.deleeuw{at}intmed.unimaas.nl.

Abstract--In studies on carotid artery intima-media thickness and stroke, researchers implicitly assume that cerebrovascular abnormalities show a symmetrical distribution. To evaluate whether there is a difference in intima-media thickness between the 2 carotids, we compared left and right common carotid artery intima-media thickness as measured by B-mode ultrasonography in a group of 102 untreated hypertensive patients. This yielded a significant difference between both sides (left, 0.75±0.11 mm; right, 0.71±0.11 mm; P<0.001). This was associated with a higher cross-sectional area of the intima-media complex and a higher flow velocity at the left side. Arterial diameters, however, were not different. We also assessed whether there is a side preference with respect to cerebrovascular accidents. To this end, we explored our population-based Stroke Registry of 1843 subjects and indeed found a significantly higher incidence of nonlacunar cerebrovascular stroke at the left side, whereas lacunar infarcts were symmetrically distributed. Our findings suggest a predilection for cerebrovascular disease at the left side, which may be related to greater hemodynamic stress and intimal damage in the left carotid artery.

Key words: carotid arteries • atherosclerosis • cerebral arteries • stroke

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