Document Detail


Diversity of single small subcortical infarctions according to infarct location and parent artery disease: analysis of indicators for small vessel disease and atherosclerosis.
MedLine Citation:
PMID:  20966406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Single small subcortical infarctions (SSSIs), so-called lacunae, are typically caused by lipohyalinosis of a perforator artery. However, SSSIs can be caused by underlying large parent arterial disease or microatheroma of the proximal portion of a perforator artery. We sought to investigate whether indicators for small vessel disease (SVD) and atherosclerosis in patients with SSSI differ according to lesion location and the presence of parent artery disease.
METHODS: We assessed 449 patients who had an SSSI (lesion diameter ≤ 20 mm) in the perforator territory of middle cerebral artery (n = 244), basilar artery (n= 141), and vertebral artery (n = 64) on diffusion-weighted imaging performed within 48 hours of stroke onset. We divided SSSI into 3 groups according to lesion location and the presence of parent artery disease: (1) SSSI with parent artery disease (SSSI+PAD); (2) proximal SSSI without PAD (pSSSI-PAD); and (3) distal SSSI without PAD (dSSSI-PAD). The prevalence of SVD indicators (leukoaraiosis and microbleeds) and atherosclerosis indicators (cerebral atherosclerosis and coronary heart disease) were compared among the groups.
RESULTS: SSSI+PAD had the highest prevalence of atherosclerosis indicators and the lowest prevalence of SVD indicators, whereas dSSSI-PAD had the lowest prevalence of atherosclerosis indicators and the highest prevalence of SVD indicators. pSSSI-PAD showed intermediate features. Atherosclerosis indicators significantly increased and SVD indicators significantly decreased as the vascular territory became lower (from middle cerebral artery, basilar artery to vertebral artery).
CONCLUSIONS: Differences in SVD and atherosclerosis indicators suggest that SSSI has a heterogeneous pathogenesis according to lesion location and the presence of PAD.
Authors:
Hyun-Wook Nah; Dong-Wha Kang; Sun U Kwon; Jong S Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-21
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2822-7     Citation Subset:  IM    
Affiliation:
Stroke Center and Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atherosclerosis / pathology*
Basilar Artery / pathology
Brain Ischemia / complications,  pathology
Cerebral Arterial Diseases / complications,  pathology*
Cerebral Infarction / complications,  pathology*
Coronary Disease / complications,  pathology
Diffusion Magnetic Resonance Imaging
Female
Humans
Image Processing, Computer-Assisted
Infarction, Middle Cerebral Artery / pathology
Leukoaraiosis / pathology
Male
Middle Aged
Risk Factors
Stroke / etiology,  pathology
Vertebral Artery / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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