Imaging of the neck artery can reveal the patients most at risk of stroke, according to a new study.
Having narrowed carotid arteries - which run through the neck and serve the brain - increases the risk of a stroke. But some people are more vulnerable than others. It depends upon the actual state of the blockage - or plaque - within the carotids, say researchers at the University of Washington, Seattle, USA.

They looked at the state of the carotid arteries in 53 patients who were scheduled for a carotid endarterectomy - a procedure that removes the plaque. They used magnetic resonance imaging (MRI) - a non-invasive technique which is generally used to look at body organs - and found that the plaque could be in three states, dependent on its outer surface or cap. Unstable cap was linked to a 23 times greater risk of a stroke.

There was also a link between the patient's cap status and clinical history. Seventy per cent of those with an unstable cap had already had a transient ischaemic attack (TIA or ministroke), while 50 per cent with a stable, but thin, cap had had a TIA. But only nine per cent with a stable cap - less likely to rupture - had had a TIA. The study strongly suggests that you could use MRI to pick out those people with carotid narrowing who are most at risk of a stroke.