Multiple acute stroke syndrome -: Marker of embolic disease?
Multiple acute stroke syndrome -: Marker of embolic disease?
复制标题
DOI：
10.1212/wnl.54.3.674
复制
发表时间：
2000-02-08
期刊：
影响因子：
9.9
通讯作者：
Warach, S
中科院分区：
文献类型：
--
作者：
Baird, AE;Lövblad, KO;Warach, S
目的：探讨脑卒中急性期多发性缺血性病变的发生率及其病因学意义。背景资料：虽然患者在其一生中可能发生不止一次中风，但急性缺血性中风通常被认为是单一事件。使用弥散加权成像（DWI），一种在发病后几分钟内检测缺血性损伤的MRI技术，我们经常观察到多个急性缺血性病变。研究方法：对59例连续研究患者的MRI扫描进行回顾，以确定DWI上多发急性缺血性病变的频率和病因学意义。结果：59例患者中有10例（17%）存在多发性急性缺血性病变。病变通常发生在一个主要循环（前或后），但在2例患者（3%）中，病变发生在两个大脑半球或在前和后循环。病变通常很小，由假定的多发性栓子或栓子破裂引起。2例患者有颈内动脉闭塞性疾病，4例有心脏或主动脉源。在其他4例患者中，未确定来源。直径大于1 cm的病变进展为梗死，但随访T2加权成像未发现一些较小的病变。结论：DWI上多发性急性脑卒中病灶很常见，可能是由多发性栓子或栓子破裂引起的。在某些情况下，可能会对中风机制做出早期推断，这可能有助于立即指导患者的临床检查和治疗。
Objective: To determine the frequency and etiologic significance of multiple acute ischemic lesions in stroke. Background: Although patients may have more than one stroke during the course of their lives, acute ischemic stroke is usually thought of as a single event. Using diffusion-weighted imaging (DWI), an MRI technique that detects ischemic injury within minutes after onset, we have often observed multiple acute ischemic lesions. Methods: The MRI scans of 59 consecutively studied patients were reviewed to determine the frequency and etiologic significance of multiple acute ischemic lesions on DWI. Results: Multiple acute ischemic lesions were present in 10 (17%) of 59 patients. The lesions usually occurred within one major circulation (anterior or posterior), but in two patients (3%), lesions occurred in both cerebral hemispheres or in the anterior and the posterior circulations. The lesions often were small and resulted from presumed multiple emboli or the break-up of an embolus. Two patients had internal carotid artery occlusive disease and four had a cardiac or aortic source. In the other four patients the source was not determined. Lesions larger than 1 cm in diameter progressed to infarction, but some smaller lesions were not seen on follow-up T2-weighted imaging. Conclusions: Multiple acute stroke lesions on DWI are common and could be caused by multiple emboli or the breakup of an embolus. In some cases it might become possible to make early inferences concerning the stroke mechanism that could be of use for immediately directing the clinical work-up and treatment of the patient.