Acute Diffusion-Weighted Imaging Lesion Patterns Predict Progressive Small Subcortical Infarct in the Perforator Territory of the Middle Cerebral Artery

作者：Zuowei Duan, Wen He Sun, Wenhua Liu, Lulu Xiao, Zhixin Huang, Liping Cao, Hua Li, Yunyun Xiong, Dezhi Liu, Gelin Xu, Xinfeng Liu · 发表于：International Journal of Stroke · 年份：2014 · DOI：10.1111/ijs.12352 · 被引用次数：29 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Moyamoya disease diagnosis and treatment

BACKGROUND: Single small subcortical infarct (SSSI) is generally considered to have a fair outcome. However, early neurological deterioration (END), a relatively unfavorable clinical course occurring during the acute phase of infarction, is not uncommon. AIMS: The aim of this study was to investigate the relationship between lesion patterns detected by diffusion-weighted imaging (DWI) and the presence of END in patients with acute SSSI in the perforator territory of the middle cerebral artery (MCA). METHODS: Three hundred twelve patients with acute SSSI in the perforator territory of MCA were prospectively recruited from Jinling Hospital between January 2010 and May 2013. Acute DWI lesion patterns were classified as proximal SSSI (pSSSI) or distal SSSI (dSSSI) patterns, according to the relationship between lesion location and the parent artery. Neurological deficits were evaluated using the National Institutes of Health Stroke Scale (NIHSS) at admission and continued over the following 72 h 1-3 times a day. END was defined as an increase in NIHSS score ≥ 2 points during the first 72 h after admission. RESULTS: Of the total 312 patients, the pSSSI pattern was found in 139 (44.55%) patients and the dSSSI pattern in 173 (55.45%) patients. Statistical analysis suggested that the indicators for small-artery disease (hypertension and leukoaraiosis) and atherosclerosis (diabetes mellitus and cerebral atherosclerosis) significantly differed according to lesion patterns (P < 0.05). D...