Classification and natural history of clinically identifiable subtypes of cerebral infarction

Bamford, John; Sandercock, Peter; Dennis, Martin; Burn, John; Warlow, Charles

doi:10.1016/0140-6736(91)93206-o

Cited by 2,971 publications

(2,152 citation statements)

References 24 publications

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“…All patients presented to the same regional teaching hospital between: 2002 and 2005 ( n = 87) (Study 1; Jackson et al., 2009), 2005 and 2007 ( n = 32) (Study 2; Wardlaw et al., 2009), and 2010 and 2013 ( n = 75) (Study 3; Munoz Maniega et al., 2016). Patients from Study 1 included all OCSP (Oxfordshire Community Stroke Project; Bamford, Sandercock, Dennis, Burn, & Warlow, 1991) ischemic stroke subtypes, whereas patients from Studies 2 and 3 included lacunar, partial anterior, and posterior circulation stroke syndromes only. However, we only included those who had presented with an acute lacunar stroke syndrome according to the OCSP classification and who had a corresponding RSSI visible on DWI.…”

Section: Methodsmentioning

confidence: 99%

Interhemispheric characterization of small vessel disease imaging markers after subcortical infarct

et al. 2016

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BackgroundIn structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown.Materials and MethodsFrom brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)‐positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces. We registered all images to an age‐relevant brain template and calculated the probability distribution of all SVD markers mentioned for patients who had the RSSI in each hemisphere separately. We used the Wilcoxon and chi‐squared tests to compare the volumes and frequencies of occurrence, respectively, of the SVD markers between hemispheres throughout the sample.ResultsFifty‐two percent patients (n = 97) had the RSSI in the left hemisphere, 42% (n = 78) in the right, 2.7% (n = 5) in both, and 3.7% (n = 7) in the cerebellum or brainstem. There was no significant difference in RSSI frequency between left and right hemispheres (p = .10) in the sample. The median volume of the RSSI (expressed as a percentage of the total intracranial volume) was 0.05% (IQR = 0.06). There was no difference in median percent volume of the right RSSIs versus left (p = .16). Neither was there a significant interhemispheric difference in the volume of any of the SVD markers regardless of the location of the RSSI and they were equally distributed in both hemispheres.ConclusionAssessment of SVD imaging markers in the contralateral hemisphere could be used as a proxy for the SVD load in the whole brain to avoid contamination by the RSSI of the measurements, especially of WMH.

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Section: Methodsmentioning

confidence: 99%

Interhemispheric characterization of small vessel disease imaging markers after subcortical infarct

et al. 2016

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“…Stroke-subtypes were defined into total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), lacunar infarcts (LACI) and posterior circulation infarcts (POCI) [10]. All patients underwent a routine blood investigation and electrocardiography.…”

Section: Protocol For T-pa Treatmentmentioning

confidence: 99%

Safety of routine IV thrombolysis between 3 and 4.5 h after ischemic stroke

Uyttenboogaart

Vroomen

Stewart

et al. 2007

Journal of the Neurological Sciences

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Background: The administration of tissue plasminogen activator (t-PA) has been proven effective for ischemic stroke within 3 h after onset. A pooled-analysis of six trials showed that intravenous t-PA still improves outcome when given between 3 to 4.5 h after stroke onset. On the basis of this pooled analysis, t-PA was also routinely offered to our patients between 3-4.5 h. We report the safety and clinical features of this group together with the features of the group given t-PA within 3 h. Methods: Prospectively patient characteristics, stroke severity, stroke subtype, incidence of symptomatic intracerebral hemorrhage (SICH), in-hospital mortality, and 3-months modified Rankin Scale scores (mRS) were registered. Data was analyzed separately for patients treated within 3 h (early group) and those treated between 3-4.5 h (late group). Results: Among 176 patients who underwent intravenous thrombolysis, 101 were treated in the early group and 75 in the late group. Six (5.9%; 95% CI 2.8%-12.3%) patients in the early group and 4 (5.3%; 95% CI 2.2%-12.9%) in the late group developed SICH (p = 1.0). In the early group 13 (12.9%; 95% CI 7.7%-20.8%) patients died within 7 days after admission, compared to 5 (6.7%; 95% CI 3.0%-14.7%) in the late group (p = 0.179). In the early group 44 (43.6%; 95% CI 43.3%-53.3%) were independent (mRS ≤ 2) at three months, compared to 36 (48.0%; 95% CI 37.0%-59.1%) in the late group (p = 0.559). Conclusion: Our data show no trend of decreased safety of thrombolysis beyond 3 h. Due to a small sample size a harmful effect cannot be excluded but seems unlikely.

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“…14 All patients had haemorrhagic stroke excluded on the basis of computed topographic (CT) head scan and therefore were classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarct (POCI).…”

Section: Clinical Stroke Classificationmentioning

confidence: 99%

Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’ (TAIST)

Sprigg

Gray

Bath

et al. 2007

Journal of the Neurological Sciences

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Classification and natural history of clinically identifiable subtypes of cerebral infarction

Cited by 2,971 publications

References 24 publications

Interhemispheric characterization of small vessel disease imaging markers after subcortical infarct

Interhemispheric characterization of small vessel disease imaging markers after subcortical infarct

Safety of routine IV thrombolysis between 3 and 4.5 h after ischemic stroke

Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’ (TAIST)

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