Imaging features of acute small subcortical infarcts: comparison of large artery atherosclerotic and small artery disease stroke / 国际脑血管病杂志

ABSTRACT

Objective To investigate the differences in neuroimaging between large artery atherosclerosis and small subcortical infarction (SSI). Methods The consecutive hospitalized patients with acute SSI were divided into large atherosclerotic stroke group and small-artery occlusive stroke group according to the evidence-based etiolologic classification of ischemic stroke (the SSS-TOAST criteria). The neuroimaging features between the two groups were compared.Results A total of 118 patients with SSI were recruited. Seven patients with cardiogenic cerebral embolism were excluded from the study. Three were stroke of other determined etiology and 7 were cryptogenic stroke. Twenty-six patients in the large artery atherosclerotic stroke group had new infarcts (3.69 ± 5. 79), 50％ of them were multiple lesions, mainly a half oval in the center (P ＜0. 01); 75 patients in the small-artery occlusive stroke group had new infarcts (1.08 ±0. 51), only 3 (3.7％) were mltiple lesions, and they were in the different artery territories.Compared to the large atherosclerotic stroke group, the white matter lesions was more severe in the small-artery occlusive stroke group (P =0. 04), and most of them were accompanied by silent infarction (P =0. 012). Conclusions The large atherosclerotic SSI was mostly multiple infarcts in a half oval in the center, while the small artery occlusive SSI was mostly single infarct, and was usually accompanied by severe white matter lesions and silent infarction.