The course of patients with lacunar infarcts and a parent arterial lesion - Similarities to large artery vs small artery disease
The course of patients with lacunar infarcts and a parent arterial lesion - Similarities to large artery vs small artery disease
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DOI：
10.1001/archneur.61.4.514
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发表时间：
2004-04-01
影响因子：
--
通讯作者：
Huh, K
中科院分区：
文献类型：
--
作者：
Bang, OY;Joo, SY;Huh, K
背景：弥散加权成像中腔隙综合征 (LS) 和小深度梗死 (SDI) 患者载瘤动脉闭塞性病变的意义尚不清楚。目的：比较有载瘤动脉病变和无载瘤动脉病变的 LS 和 SDI 患者中风的复发情况。设计：分析来自前瞻性急性卒中登记的数据。地点：大学医院。患者：利用临床综合征、弥散加权成像和血管研究，我们将173 名患者分为 3 组：(1) 闭塞深部穿支 (PAD) 的载瘤动脉疾病、伴有 SDI 的 LS 和载瘤动脉病变 (n=32)； (2) 小动脉疾病 (SAD) (n=70) 和 (3) 大动脉疾病 (LAD) (n=71)。主要指标：记录1年的复发性卒中及预后，并将PAD组的预后与SAD和LAD组进行比较。结果：随访期间，死亡9例（6例血管性死亡），复发性卒中18例。 PAD 组的复发率 (16%) 显着高于 SAD 组 (1%) (P=.01)，但与 LAD 组 (17%) 相似 (P=.87)。载瘤动脉病变的存在是 LS 和 SDI 患者中风复发的唯一独立预测因素（比值比，13.8；95% 置信区间，1.5-123.9；P=.02）。结论：虽然检查时的 LS、弥散加权成像的 SDI 以及稳定的医院病程表明良性病程的腔隙性中风，但我们的结果表明，PAD 组代表了一种颅内类型的中风。小伙子。
Background: The significance of occlusive lesions of the parent artery in patients with lacunar syndrome (LS) and small deep infarcts (SDIs) on diffusion-weighted imaging remains unclear.Objective: To compare the recurrence of stroke in patients with LS and SDIs between those with vs without a parent arterial lesion.Design: Analysis of data from a prospective acute stroke registry.Setting: University hospital.Patients: Using clinical syndrome, diffusion-weighted imaging, and vascular studies, we divided 173 patients into 3 groups: (1) parent arterial disease occluding deep perforators (PAD), LS with SDIs, and a parent arterial lesion (n=32); (2) small artery disease (SAD) (n=70) and (3) large artery disease (LAD) (n=71). Main Outcome Measures: Recurrent strokes and the prognosis were registered for 1 year, and the outcome of the PAD group was compared with that of the SAD and LAD groups.Results: During follow-up, there were 9 deaths (6 vascular) and 18 recurrent strokes. The recurrence rate in the PAD group (16%) was significantly higher than that in the SAD group (1%) (P=.01) but similar to that in the LAD group (17%) (P=.87). The presence of the parent arterial lesion was the only independent predictor of stroke recurrence in patients with LS and SDIs (odds ratio, 13.8; 95% confidence interval, 1.5-123.9; P=.02).Conclusions: Although LS on examination, SDIs on diffusion-weighted imaging, and a stable hospital course suggest lacunar stroke of benign course, our results indicate that the PAD group represents an intracranial type of LAD.