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Abstract
It is well known that hypercholesterolemia is correlated with coronary atherosclerosis,
but no definite information is available on its association with cerebrovascular atherosclerosis.
We studied 10 young patients (age 3–32 years) with homozygous familial hypercholesterolemia
(FH), together with 3 normal relatives as healthy controls. Extra- and intracranial
Doppler examination, MRI and cerebral blood flow by SPECT and99mTc-HM-PAO were performed on all. Six out of 10 patients already had signs and symptoms
of coronary heart disease, but all patients were free from ischemic brain lesions,
as small as detectable at MRI, and had normal cerebral blood flow. Two patients presented
significant stenosis of the carotid arteries at Doppler examination. Young patients
with homozygous FH have early and clinically evident coronary atherosclerosis, while
overt disease in the cerebral district is delayed despite the extremely elevated plasma
cholesterol concentration. This was also confirmed by the autopsy of two patients,
who died after the study and whose cerebral arteries were totally free from atherosclerotic
lesions. The age, at which flow-reducing atherosclerotic lesions develop in hypercholesterolemic
patients, differs with regard to the arterial district involved.
Keywords
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Article info
Publication history
Accepted:
June 3,
1991
Received in revised form:
May 31,
1991
Received:
March 22,
1991
Identification
Copyright
© 1991 Published by Elsevier Inc.