Acute Simultaneous Multiple Lacunar Infarcts: A Severe Disease Entity in Small Artery Disease
Acute Simultaneous Multiple Lacunar Infarcts: A Severe Disease Entity in Small Artery Disease
复制标题
DOI：
10.1159/000336061
复制
发表时间：
2012-01-01
影响因子：
2.4
通讯作者：
Kim, Hahn Young
中科院分区：
文献类型：
--
作者：
Lee, Joon Hwa;Kim, Young Jin;Kim, Hahn Young
背景：我们假设急性同时多发腔隙性梗死（sMLI）与急性单腔隙性梗死（SLI）相比可能具有不同的临床放射学特征。方法：我们回顾性地回顾了连续收集的卒中登记和预先确定的长期临床随访中患有轻度语言障碍或特殊语言障碍的卒中患者。评估临床特征，包括血管危险因素、流变学特征、发病前功能状态和临床结果。此外，影像学特征包括白质缺血性改变、既往腔隙、微出血和伴发颅内或颅外动脉狭窄进行评估。结果：548例急性缺血性脑卒中患者中，sMLI 23例（13.5%），SLI 148例（86.5%）。两组之间的血管危险因素和流变学特征没有差异，除了sMLI组的高龄和更频繁的卒中史。sMLI组既往有更多的腔隙（p < 0.001）和微出血（p < 0.001）。心脏栓塞或动脉粥样硬化血栓性卒中机制在两组中都很少见。复发性卒中在sMLI组更为频繁。结论：sMLI的主要病理生理机制可能是小动脉病变。然而，临床放射学特征表明，与SLI相比，sMLI可能是一种更严重的小动脉疾病。巴塞尔S. Karger股份有限公司版权所有
Background: We hypothesized that acute simultaneous multiple lacunar infarcts (sMLI) may have different clinico-radiological characteristics compared to acute single lacunar infarcts (SLI). Methods: We retrospectively reviewed stroke patients with sMLI or SLI in a consecutively collected stroke registry with a predefined long-term clinical follow-up. Clinical characteristics, including vascular risk factors, rheological profiles, premorbid functional status, and clinical outcome were evaluated. In addition, radiological characteristics, including white matter ischemic changes, previous lacunes, microbleeds, and concomitant intra-or extracranial arterial stenosis were evaluated. Results: Of the 548 acute ischemic stroke patients, sMLI was found in 23 (13.5%) and SLI in 148 (86.5%). There was no difference in vascular risk factors and rheological profiles between the two groups, except for advanced age and more frequent previous history of stroke in the sMLI group. The sMLI group also showed more previous lacunes (p < 0.001) and microbleeds (p < 0.001). A cardioembolic or atherothrombotic stroke mechanism was rare in both groups. Recurrent strokes were more frequent in the sMLI group. Conclusions: The main pathophysiology of sMLI may be small artery disease. However, clinico-radiological characteristics suggest that sMLI may be a more severe entity of small artery disease compared to SLI. Copyright (C) 2012 S. Karger AG, Basel