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

Yamamoto, Yasumasa; Ohara, Tomoyuki; Hamanaka, Masashi; Hosomi, Akiko; Tamura, Akiyoshi; Akiguchi, Ichiro; Ozasa, Kotaro

doi:10.1016/j.jns.2009.08.065

Cited by 64 publications

(72 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PMD is defined as the deterioration of a NIHSS motor score ! 1 during the first 7 days after stroke onset (13,18,19). There were thirty cases of lacunae-sized infarctions in patients with PMD (PMD group) and 45 cases of patients with NPMD (NPMD group) in this study.…”

Section: Clinical Assessmentmentioning

confidence: 84%

See 1 more Smart Citation

The Infarct Shape Predicts Progressive Motor Deficits in Patients with Acute Lacunae-sized Infarctions in the Perforating Arterial Territory

Tan

2015

Intern. Med.

View full text Add to dashboard Cite

ObjectiveThis study was performed to analyze the lesion patterns of lacunae-sized infarctions on diffusionweighted imaging (DWI) findings in the perforating arterial territory, and to determine whether this pattern of satellite lesions affected progressive motor defect (PMD). Methods Seventy-five patients with acute lacunae-sized infarctions in the perforating arterial territory (pons or territory of the lenticulostriate arteries), which was confirmed by cranial magnetic resonance image (MRI), were enrolled in this study. These patients were divided into PMD (n=30) and non-progressive motor defect (NPMD) (n=45) groups according to the dynamic scores of the National Institutes of Health Stroke Scale (NIHSS) within 7 days after stroke. The lesion patterns of lacunae-sized infarctions were divided into single oval or satellite lesions signs based on DWI. The risk factors of stroke and the clinical characteristics of all the subjects, including neurological deficits, infarction lesion patterns in image, and the condition of the basilar artery, were comparatively analyzed. Results The constituent ratio of satellite lesions signs [20/30 (66.7%)] in the PMD group was higher than that [10/45 (22.2%)] of the NPMD group (χ 2 = 6.1, p=0.013). Mean NIHSS scores in the PMD group on admission were higher than that of the NPMD group (4.60±1.40 vs. 3.75±1.2, t=2.81, p=0.003). A logistic regression analysis showed that the pattern of satellite lesions was associated with PMD. odds ratio (OR): 3.0, 95% confidence interval (CI) 1.25-7.17, p=0.014 . Conclusion Satellite lesions are one of the features of lacunae-sized infarctions patterns, which might be an independent predictor in DWI findings for PMD in patients with lacunae-sized infarctions in the perforating arterial territory.

show abstract

Section: Clinical Assessmentmentioning

confidence: 84%

“…PMD is defined as the deterioration of the NIHSS motor score ! 1 during the first 7 days after stroke onset (13,18,19). The predication and management of progressing stroke has been a major clinical problem.…”

Section: Discussionmentioning

confidence: 99%

The Infarct Shape Predicts Progressive Motor Deficits in Patients with Acute Lacunae-sized Infarctions in the Perforating Arterial Territory

Tan

2015

Intern. Med.

View full text Add to dashboard Cite

show abstract

“…In accordance with clinical features and followed mRS score, two types of MIS were delineated: 1) Stable MIS: those MIS with a stable or benign course [3] [4], and with a followed mRS score of 0 -1; 2) Progressive MIS: including two subtypes (a) acute progressive MIS: any symptoms rapidly progress or recurrent new symptoms, and lesions rapidly evolution or extension during the first 7 days after onset; or adds at least 1 point to scores by National Institutes of Health Stroke Scale (NIHSS) [8], and with a followed mRS score of 2 -6 at 6 months follow-up; (b) chronic progressive MIS: symptoms slowly occurring for more than a few months; frequent transient symptoms or new ischemic event tend to progress slowly; or with chronic progressive neurologic decline and normal pressure hydrocephalus [12], or chronic or acute-onchronic white matter ischaemia [13], and with a mRS score of 2 -6 at 6 months follow-up.…”

Section: Outcome Evaluationmentioning

confidence: 99%

Clinical Types and Outcome of Minor Ischemic Stroke in Northern China: A Retrospective Cohort Study

Wang¹,

Tong²,

Chen³

et al. 2017

WJNS

View full text Add to dashboard Cite

Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types and outcome in the elderly in northern China. Methods: A retrospective cohort of consecutive patients was selected for study; all registered neurologic outpatients of the tertiary teaching hospital in northern Jiangsu, China between February, 2011 and February, 2012. A total of 433 outpatients, clinically only having had an initial visit and a MRI study of the brain, were enrolled. Results: Of 433 outpatients, 247 (57.0%) patients with MIS were diagnosed. The clinical types of MIS included stable MIS in 58.3%, acute progressive MIS in 5.3%, and chronic progressive MIS in 36.4% of patients. After adjusted Odd ratio (OR), only aged (OR, 1.0; 95% confidence interval [CI], 1.007 -1.087, p = 0.021), episode duration (OR, 1.8; 95% CI, 1.011 -1.024, p = 0.001), initial number of MIS (OR, 1.1; 95% CI, 1.047 -1.207, p = 0.001), and infarcts volume (OR, 1.8; 95% CI, 1.253 -2.681, p = 0.002) were independently associated with stable MIS and progressive MIS. Total survival was favorable among groups (p = 0.094), but the followed mRS score was significantly higher among those progressive MIS than those stable MIS (2.3 ± 1.0 vs 0.1 ± 0.3, p < 0.001). Conclusion: MIS had a very high prevalence and different clinical types. Stable MIS is a benign stroke, whereas those progressive MIS may have long-term instability or acute and chronic progressive trend. This information is important in prospectively determining outcome of MIS and in patient treatment.

show abstract

“…Early motor worsening (EMW) is a significant event encountered frequently in the acute phase of penetrating artery infarctions [1,2,3]. Predictive factors of EMW are not fully understood [4].…”

Section: Introductionmentioning

confidence: 99%

“…Predictive factors of EMW are not fully understood [4]. Diabetes mellitus in patients with penetrating artery infarction is known to be associated with EMW [1,3]. However, in patients with penetrating artery infarction in whom the presence of diabetes mellitus was unknown before ictus, 32% were newly diagnosed with abnormal glucose tolerance, and 12% were diagnosed with diabetes mellitus [5].…”

Section: Introductionmentioning

confidence: 99%

High Glycated Hemoglobin Levels and Intracranial Artery Stenosis Are Predictive Factors for Early Motor Worsening Events in Patients with Penetrating Artery Infarction

Isa¹,

Sakima²,

Nakachi³

et al. 2012

Eur Neurol

View full text Add to dashboard Cite

Background: The purpose of this study was to identify typical clinical characteristics to predict early motor worsening (EMW) of patients with penetrating artery infarction. Methods: We reviewed 65 consecutive patients with pure motor hemiparesis, sensorimotor stroke, and ataxic hemiparesis. EMW was defined as deterioration by ≥1 point on the National Institutes of Health Stroke Scale for motor function within 5 days of admission. Results: EMW was observed in 22 patients (34%). HbA1c levels were higher in patients with EMW than in those without EMW (7.9 ± 2.6 vs. 6.3 ± 1.6%; p < 0.01). The percentage of EMW patients with intracranial artery stenosis (ICAS) was greater than that of non-EMW patients with ICAS (13/22 patients, 59% vs. 8/43 patients, 19%; p < 0.01). Multivariate logistic regression analysis indicated that HbA1c levels ≥7.0% (OR 3.0, 95% CI 1.5–6.8; p < 0.005) or ICAS (OR 2.3, 95% CI 1.2–4.8; p < 0.05) increased the risk of EMW, and the combination of these factors increased the risk in an additive manner (OR 7.6, 95% CI 2.5–40; p < 0.005). Conclusion: HbA1c levels ≥7.0% and/or ICAS in patients with penetrating artery infarction are associated with EMW.

show abstract

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

Cited by 64 publications

References 27 publications

The Infarct Shape Predicts Progressive Motor Deficits in Patients with Acute Lacunae-sized Infarctions in the Perforating Arterial Territory

The Infarct Shape Predicts Progressive Motor Deficits in Patients with Acute Lacunae-sized Infarctions in the Perforating Arterial Territory

Clinical Types and Outcome of Minor Ischemic Stroke in Northern China: A Retrospective Cohort Study

High Glycated Hemoglobin Levels and Intracranial Artery Stenosis Are Predictive Factors for Early Motor Worsening Events in Patients with Penetrating Artery Infarction

Contact Info

Product

Resources

About