Arboix A, Padilla I, Massons J, García-Eroles L, Comes E, Targa C
Acute Stroke Unit, Service of Neurology, Hospital del Sagrat Cor, Viladomat 288, E-08029 Barcelona, Spain.
J Neurol Neurosurg Psychiatry. 2001 Aug;71(2):239-42. doi: 10.1136/jnnp.71.2.239.
The objective was to assess the frequency of pure motor stroke caused by different stroke subtypes and to compare demographic, clinical, neuroimaging, and outcome data of pure motor stroke with those of patients with other lacunar stroke as well as with those of patients with non-lacunar stroke. Data from 2000 patients with acute stroke (n=1761) or transient ischaemic attack (n=239) admitted consecutively to the department of neurology of an acute care 350 bed teaching hospital were prospectively collected in the Sagrat Cor Hospital of Barcelona stroke registry over a 10 year period. For the purpose of the study 222 (12.7%) patients with pure motor stroke were selected. The other study groups included 218 (12.3%) patients with other lacunar strokes and 1321 (75%) patients with non-lacunar stroke. In relation to stroke subtype, lacunar infarcts were found in 189 (85%) patients, whereas ischaemic lacunar syndromes not due to lacunar infarcts occurred in 23 (10.4%) patients (atherothrombotic stroke in 12, cardioembolic stroke in seven, infarction of undetermined origin in three, and infarction of unusual aetiology in one) and haemorrhagic lacunar syndromes in 10 (4.5%). Patients with pure motor stroke showed a better outcome than patients with non-lacunar stroke with a significantly lower number of complications and in hospital mortality rate, shorter duration of hospital stay, and a higher number of symptom free patients at hospital discharge. After multivariate analysis, hypertension, diabetes, obesity, hyperlipidaemia, non-sudden stroke onset, internal capsule involvement, and pons topography seemed to be independent factors of pure motor stroke in patients with acute stroke. In conclusion, about one of every 10 patients with acute stroke had a pure motor stroke. Pure motor stroke was caused by a lacunar infarct in 85% of patients and by other stroke subtypes in 15%. Several clinical features are more frequent in patients with pure motor stroke than in patients with non-lacunar stroke.
目的是评估不同卒中亚型所致纯运动性卒中的发生率，并比较纯运动性卒中患者与其他腔隙性卒中患者以及非腔隙性卒中患者的人口统计学、临床、神经影像学和预后数据。在10年期间，前瞻性收集了巴塞罗那圣心医院卒中登记处连续收治到一家拥有350张床位的急性护理教学医院神经内科的2000例急性卒中患者（n = 1761）或短暂性脑缺血发作患者（n = 239）的数据。为了该研究目的，选择了222例（12.7%）纯运动性卒中患者。其他研究组包括218例（12.3%）其他腔隙性卒中患者和1321例（75%）非腔隙性卒中患者。关于卒中亚型，189例（85%）患者发现有腔隙性梗死，而23例（10.4%）患者发生了非腔隙性梗死所致的缺血性腔隙综合征（12例为动脉粥样硬化血栓形成性卒中，7例为心源性栓塞性卒中，3例为病因不明的梗死，1例为病因不寻常的梗死），10例（4.5%）为出血性腔隙综合征。纯运动性卒中患者的预后优于非腔隙性卒中患者，并发症数量和住院死亡率显著更低，住院时间更短，出院时无症状患者数量更多。多因素分析后，高血压、糖尿病、肥胖、高脂血症、非突然起病、内囊受累和脑桥部位似乎是急性卒中患者纯运动性卒中的独立因素。总之，每10例急性卒中患者中约有1例为纯运动性卒中。85%的纯运动性卒中患者由腔隙性梗死引起，15%由其他卒中亚型引起。纯运动性卒中患者的几种临床特征比非腔隙性卒中患者更常见。
