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Clinical Evaluation of Lacunar Infarction and Branch Atheromatous Disease.
MedLine Citation:
PMID:  22133744     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Patients with branch atheromatous disease (BAD) are more likely to experience neurologic deficits compared with those with lacunar infarction (LI), although both disorders are forms of intracranial deep brain infarction. We clinically evaluated patients with BAD (n = 42) and LI (n = 57) to investigate why patients with BAD tend to experience progressing stroke. Patients presenting to our hospital with acute ischemic stroke between April 2008 and March 2009 were screened. LI was defined as an intracerebral lesion <15 mm in diameter and fewer than 3 slices or a lesion within the pontine parenchyma. BAD was defined as an intracerebral lesion of ≥15 mm in diameter and more than 3 slices or a lesion extending to the surface of the pontine base observed on diffusion-weighted magnetic resonance imaging. Progressing stroke was defined as a >2-point increase in the National Institutes of Health Stroke Scale within 48 hours of stroke onset. Progressing stroke was significantly more prevalent in the BAD group compared with the LI group (38.1% vs 12.3%). Diabetes mellitus with a high low-density lipoprotein level was significantly prevalent in patients with progressing BAD. When BAD in the cerebrum and BAD in the pons were analyzed separately, a low-density lipoprotein level >140 mg/dL was the most prevalent risk factor for progressing BAD in the cerebrum, and patient age was the strongest risk factor for progressing BAD in the pons. Vascular lesions asvsessed by magnetic resonance angiography were significantly abundant in both progressing LI and BAD. Our findings suggest that BAD may have a poorer prognosis than LI. Poorly controlled diabetes and hyperlipidemia could lead to atherosclerosis of the branch artery, resulting in worsening of BAD.
Authors:
Taizen Nakase; Shotaroh Yoshioka; Masahiro Sasaki; Akifumi Suzuki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-29
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  -     ISSN:  1532-8511     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-12-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Stroke Science, Research Institute for Brain and Blood Vessels, Akita, Japan.
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