Abstract
The aim of this study was to identify the frequency and possible pathogenic mechanisms
of early neurological deterioration in patients with acute small non-lacunar infarction.
We studied 46 patients (35 men, 11 women; age, 70.3±10.4 years) with acute small non-lacunar
infarction. Small non-lacunar infarction was diagnosed using diffusion-weighted magnetic
resonance imaging (DWI) as being <15 mm in diameter and located in the cortex and
centrum ovale in the middle cerebral artery territory. The patients were divided into
two groups; Group D (n=6) had neurological deterioration within 7 days after symptom onset, while Group
N (n=40) did not have any neurological deterioration. In Group D, the interval from symptom
onset to clinical deterioration was 3.3±1.5 days (range 2–6 days). Blood pressure
on admission was higher in Group D than in Group N (p<0.05). In Group D, four of these five patients with follow-up DWI had new acute small
ischemic lesions in addition to the initial lesions, indicating recurrent attacks
of brain infarction. Neurological deterioration occurred within 7 days after symptom
onset in 13% of patients. Neurological deterioration was frequently caused by recurrent
infarction detected by DWI.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Progressing stroke.in: Fisher M. Bogousslavsky J. Current Review of Cerebrovascular Disease. Current Medicine Inc, Philadelphia (PA)1999: 149-160
- Neurological deterioration in acute ischemic stroke. Potential predictors and associated factors in European cooperative acute stroke study (ECASS) I.Stroke. 1999; 30: 2631-2636
- Neurological deterioration in acute lacunar infarctions: the role of excitatory and inhibitory neurotransmitters.Stroke. 2001; 32: 1154-1161
- Progressive motor deficits in lacunar infarction.Neurology. 1999; 52: 29-33
- Progressive stroke caused by CT-verified small deep infarcts; relation with the size of the infarct and clinical outcome.Acta Neurol. Scand. 1985; 71: 328-330
- Small centrum ovale infarcts on diffusion-weighted magnetic resonance imaging.Stroke. 2002; 33: 1541-1544
- Spotty cortical enhancement detected by magnetic resonance imaging: a sign of embolic transient ischemic attack and stroke?.J. Stroke Cerebrovasc. Dis. 2001; 10: 19-22
- Acute human stroke studied by whole brain echo planar diffusion-weighted magnetic resonance imaging.Ann. Neurol. 1995; 37: 231-241
- Arterial territories of human brain. Cerebral hemispheres.Neurology. 1998; 50: 1699-1708
- Centrum ovale infarcts: subcortical infarction in the superficial territory of the middle cerebral artery.Neurology. 1992; 42: 1992-1998
- Measurements of acute cerebral infarction: a clinical examination scale.Stroke. 1989; 20: 864-870
- Interobserver agreement for the assessment of handicap in stroke patients.Stroke. 1988; 19: 604-607
- Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis.N. Engl. J. Med. 1991; 325: 445-453
- Diagnosis of internal carotid artery stenosis greater than 70% with power doppler duplex sonography.AJNR Am. J. Neuroradiol. 2001; 22: 413-417
- Atherosclerotic disease of the aortic arch and the risk of ischemic stroke.N. Engl. J. Med. 1994; 331: 1474-1479
- Progressing neurological deficit secondary to acute ischemic stroke. A study on predictability, pathogenesis, and prognosis.Arch. Neurol. 1995; 52: 670-675
- Deteriorating ischemic stroke: risk factors and prognosis.Neurology. 1990; 40: 1865-1869
- Effect of blood pressure and diabetes on stroke in progression.Lancet. 1994; 344: 156-159
- Progression in acute stroke. Value of the initial NIH Stroke Scale Score on patient stratification in future trials.Stroke. 1999; 30: 1208-1212
- Fever in acute stroke worsens prognosis: a prospective study.Stroke. 1995; 26: 2040-2043
- Timing for fever-related brain damage in acute ischemic stroke.Stroke. 1998; 29: 2455-2460
- Influence of admission body temperature on stroke mortality.Stroke. 2000; 31: 404-409
Article info
Publication history
Accepted:
September 12,
2003
Received in revised form:
September 11,
2003
Received:
February 19,
2003
Identification
Copyright
© 2003 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
