Predictive factors for progressive motor deficits in penetrating artery infarctions in two different arterial territories

Abstract 

Background

Progressive motor deficits (PMD) are common in cerebral penetrating artery disease (PAD) during the acute stage and leads to severe disability. Reliable predictors and stroke mechanism for PMD in PAD have been yet to be elucidated. Moreover, difference of predictors between topographically classified PAD has not ever been systematically studied.

Methods

Three hundred ninety two consecutive patients with acute PAD (<20mm) who showed lacunar motor syndrome and admitted within 24h after onset were selected for this study. Patients were divided into 2 groups whose infarcts were topographically located within the territories of lenticulostriate arteries (LSA), and anterior pontine arteries (APA). Within each of the 2 groups, factors associated with PMD were analyzed.

Results

Progressive motor deficits were found in 55 patients (21.0%) in LSA group and 38 patients (29.0%) in APA group. In multivariate analysis, female sex and severity of motor deficit on admission (NIHSS 5 or more) were common independent predictors for PMD in both groups. The specific predictors were single infarcts without concomitant silent lacunar infarcts and preceding TIAs in LSA group and diabetes mellitus in APA group.

Conclusions

Predictive factors for PMD were different in the 2 different territory groups. Diabetes mellitus was particularly associated with PMD in APA group.

Keywords: Penetrating artery infarcts, Lenticulostriate arteries, Anterior pontine arteries, Progressive motor deficits, Diabetes mellitus, Lacunar TIAs