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Risk factors for small cortical infarction on diffusion-weighted magnetic resonance imaging in patients with acute ischemic stroke.
MedLine Citation:
PMID:  20580254     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Diffusion-weighted magnetic resonance imaging (MRI) is sensitive for detecting acute ischemic lesions. The present study evaluated risk factors associated with small cortical infarction (SCI) on diffusion-weighted MRI. We analyzed 123 patients with acute ischemic stroke retrospectively. We defined an SCI as a cortical lesions < 1.5 cm in diameter detected by diffusion-weighted MRI. Risk factors and comorbidities included hypertension, hypercholesterolemia, diabetes mellitus, cigarette smoking, potential cardiac sources of embolism, carotid disease, and coagulopathy. Carotid disease was defined as > 50% stenosis or occlusion in the internal carotid artery, detected by carotid ultrasonography. In addition, we analyzed plasma levels of coagulation and fibrinolysis markers. We also compared carotid disease, potential cardiac sources, and coagulopathy among localization of SCI. SCI was identified in 22.8% of patients with acute ischemic stroke. Carotid disease (odds ratio [OR] = 4.4; 95% confidence interval [CI] = 1.7-11.42; P = .002) and coagulopathy (OR = 6.8; 95% CI = 1.33-35.17; P = .02) were found to be independent risk factors for SCI. SCI with carotid disease was not associated with bilateral and multiple territorial lesions, whereas SCI with coagulopathy was associated with bilateral lesions. No borderzone lesions were found in SCI patients with cardiac sources. Our findings suggest that carotid disease and coagulopathy are independent risk factors for SCI. Localization of SCI varies depending on the underlying diseases.
Authors:
Chisako Yano; Makoto Iwata; Shinichiro Uchiyama
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Publication Detail:
Type:  Journal Article     Date:  2010-06-26
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  20     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2010-12-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-74     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
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