| Frequency and pathogenesis of silent subcortical brain infarction in acute first-ever ischemic stroke. | |
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MedLine Citation:
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PMID: 11868595 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We have often observed silent subcortical brain lesions on CT or MRI in first-ever ischemic stroke, but there is little published information on the relationship of these lesions to stroke subtypes. Here, we describe the incidence of MRI-detected silent subcortical brain lesions, including infarctions and white matter lesions, in a series of patients with first-ever ischemic stroke classified according to stroke subtypes. We also discuss the pathogenesis of these silent subcortical lesions. PATIENTS: We evaluated 171 patients with acute first-ever ischemic stroke. METHODS: The subjects were divided into three groups: lacunar, atherothrombotic and cardioembolic infarction groups. We evaluated silent subcortical brain infarction (SSBI), enlargement of perivascular space (EPS), and other white-matter lesions using MRI. RESULTS: Hypertension was observed in 67.6% of lacunar infarction, 57.1% of atherosclerotic infarction, and 54.1% of cardioembolic infarction. SSBI was more frequently observed in lacunar infarction than the others (lacunar vs. atherothrombotic vs. cardiogenic infarction, 81.5% vs. 44.4% vs. 42.1%, p=0.006). High-grade EPS (grade 2 or higher) was also observed more frequently in lacunar infarction than in the others (lacunar vs. atherothrombotic vs. cardiogenic infarction, 63.3% vs. 24.2% vs. 0%, p<0.001). Scheltens' score of silent subcortical lesions was significantly higher in lacunar infarction than in the others. CONCLUSIONS: The frequency of silent subcortical ischemic brain lesions was significantly higher in lacunar infarction than in atherosclerotic or cardioembolic infarction. We suggest that the pathogenesis of silent subcortical ischemic brain lesions is common to that of lacunar infarction, that is, small-vessel vasculopathy. |
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Authors:
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Tomohide Adachi; Shotai Kobayashi; Shuhei Yamaguchi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Internal medicine (Tokyo, Japan) Volume: 41 ISSN: 0918-2918 ISO Abbreviation: Intern. Med. Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-02-28 Completed Date: 2002-10-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9204241 Medline TA: Intern Med Country: Japan |
Other Details:
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Languages: eng Pagination: 103-8 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine III, Shimane Medical University, Izumo. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Brain Ischemia / epidemiology* Cerebral Infarction / classification, diagnosis, epidemiology* Comorbidity Diabetes Mellitus / epidemiology Female Heart Diseases / epidemiology Humans Hyperlipidemias / epidemiology Hypertension / epidemiology Intracranial Arteriosclerosis / epidemiology Intracranial Embolism / epidemiology Intracranial Thrombosis / epidemiology Japan / epidemiology Magnetic Resonance Imaging Male Middle Aged Risk Factors Smoking / epidemiology |
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