RÉSUMÉ
Objective To investigate the correlation between the infarction location and progressive motor deficits (PMD) occurrence.Methods The patients with middle cerebral artery(MCA) infarction within 24 h of onset without thrombolytic therapy were included.The National Institutes of Health Stroke Scale(NIHSS) motor item score increase ≥2 points of the base line within 7 d after stroke onset served as the PMD diagnostic criteria.The differences in clinical and laboratory data,and infarction location were compared between the PMD group and non-PMD group.The multivariate Logistic regression analysis predicted the risk factors of PMD occurrence.Results A total 121 patients with MCA acute cerebral infarction were included in the study and divided into the PMD group (45 cases) and non-PMD group (76 cases).The internal watershed infarction occurrencerate in the PMD group was higher than that in the non-PMD group (26.7 ％ vs.5.3％,p=0.001).The occurrence rate of penetrating arterial infarction (PAI) had no statistical difference between the PMD group and non-PMD group(42.2％ vs.35.5％,P=0.463).PAI was further divided into perforating branch atheromatous disease (BAD) and lipohyalinitic degeneration (LD).The occurrence rate of BAD in the PMD group was significantly higher than that in the non-PMD group (28.9％ vs.9.2％,P=0.005).The stepwise Logistic regression analysis indicated that watershed infarction [odds ratio (OR):9.750,95 ％ confidence interval(CI):2.828-33.612,P=0.000] and BAD lesion (OR:6.036,95 ％ CI:2.119-17.190,P =0.001) were the independent risk factors contributing to PMD.Conclusion Internal watershed infarction and BAD lesion may predict the PMD occurrence.The infarct location is conducive to find the high risk population of cerebral infarction progress.
RÉSUMÉ
Objective To investigate the imaging characteristics, clinical features and outcomes of penetrating ar-tery disease (PAD) cerebral infarction. Methods One hundred cases of cerebral infarction were divided into 44 cases of PAD group and 56 cases of LAA (large artery atherosclerosis ) group by brain MRI and neck CTA, or DSA neck artery ultrasound. The clinical features, imaging characteristics, outcome and progressive motor deficits(PMD) were compared between PAD cerebral infarction and large artery atherosclerosis (LAA) cerebral infarction. Results There were For-ty-four (44%) cases of PAD cerebral infarction, 56 (56%) cases of LAA cerebral infarction according to 2011 Chinese ischemic stroke subclassification (CISS). The smoking, drinking and TIA histories was significantly less in PAD group (27.27%) than in LAA group (50%) (P=0.021,0.023 and 0.025 respectively,);compared with LAA group, PMD occured in PAD group more frequently. (56.82% vs. 30.36%, P=0.008); lesions were located in the lateral ventricles in most PAD group which was significantly different from LAA group (52.27% vs. 21.43%, P=0.001). Modified Rankin Scale, (mRS) was not significantly different between two groups (1.43 ± 1.17 vs. 1.43 ± 1.45, P=0.99) at 3 months. Conclu-sions Patients with PAD cerebral infarction have PMD at early stage but have good prognosis at three months.