The study on the prognosis of different shapes of lacunae-sized infarctions / 中国神经精神疾病杂志

ABSTRACT

Objective To analyze lesion patterns of lacunae-sized infarctions in the perforating arterial territory in terms of shape and determine whether the lesion patterns associate with their prognosis. Methods We consecutively included patients with confirmed lacunae-sized acute ischemic infarcts in the penetrating arterial territories on diffu?sion-weighted imaging(DWI)from Guangxi stroke center between June 2012 to September 2013. Based on diffu?sion-weighted MRI, the shape of ischemic infarcts were divided into oval or conglomerated beads shape. Demographics, risk factors and NIH Stroke Scale (NIHSS) score at admission and discharge, Ranking score after three months and stroke mechanisms were analyzed. Results Among 189 patients, the conglomerated beads shape and oval shape of infarcts were detected in 69(36.5%)and 120(63.5%)patients, respectively. There were not difference between these two groups in de?mographics, risk factors and NIH Stroke Scale (NIHSS) score at admission. However, the maximal diameter of the lesion was significantly larger in the conglomerated beads shape group than in the oval shape (13.8±2.3 mm vs. 10.6±3.2 mm, P=0.006). Early neurologic deterioration was also more commonly detected in the conglomerated beads shape group than in the oval shape group (24.6% vs. 5.0%,P=0.009). Early neurologic rehabilitation was slower in the conglomerated beads shape group than in the oval shape group(30.5% vs. 10.8%,P=0.018). Multiple logistic regression analysis showed that the conglomerated beads shape was significantly associated with early neurologic deterioration (OR=7.55, 95%CI1.73~33.25,P=0.010) and was negatively related to early neurologic rehabilitation(OR=5.75, 95%CI1.53~28.70,P=0.030). Conclusions The conglomerated beads shape of lacunae infarction is significantly associated with ear?ly neurologic deterioration and is negatively related to early neurologic rehabilitation.