ABSTRACT
Objective To study the correlation between symptomatic, radiological and etiological classification in acute ischemic stroke. Methods One hundred and twenty five patients with ischemic stroke within 48 hour of onset were prospectively studied with three step diagnosis: (1) symptomatic classification based on the Oxfordshire Community Stroke Project criteria (OCSP), (2) radiological classification(CT or MRI) and (3) etiological classification based on the Lausanne Stroke Registry criteria.Results Most of the patients with symptoms of total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI) and posterior circulation infarcts (POCI) according to OCSP classification had corresponding lesions on CT or MRI, while only 67.3% of lacunar infarcts (LACI) patients had small subcortical infarction (SSI). More than 60% of patients with TACI were classified into cardioembolism (CE) in the third diagnosis, while the etiology of PACI was either CE or large artery atherosclerosis (LAA) in equal numbers. Only 57.7% of LACI patients were classified into small artery disease (SAD) and 28.8% of them into LAA, of which 80% patients had lesions other than SSI. The positive predictive value of SAD in the combination of LACI and SSI was 0.78. The etiology of POCI was variable.Conclusion Except for LACI, the symptomatic classification by OCSP corresponds well to the radiological classification. The etiological classification can be predicted in TACI and PACI, but it is hard to make in POCI, a number of LACI are due to LAA.