Nagakane Yoshinari, Naritomi Hiroaki, Oe Hiroshi, Nagatsuka Kazuyuki, Yamawaki Takemori
Department of Cerebrovascular Medicine, National Cardiovascular Center, Osaka, Japan.
Eur Neurol. 2008;60(3):137-41. doi: 10.1159/000144084. Epub 2008 Jul 14.
To find neurological or neuroimaging signs to predict neurological deterioration in acute lacunar infarctions.
Sixty-one consecutive patients with a supratentorial lacunar infarct, who were admitted within 48 h, were studied retrospectively. Progressive-type stroke (PS) was defined as progressive motor deficits that arose within 7 days after onset, by using the motor ratings of the National Institutes of Health Stroke Scale.
Sixteen patients (26%) were classified into the PS group. In the PS group, fluctuating or progressing onset (81 vs. 42%, p = 0.009), leg-predominant motor deficits on admission (63 vs. 16%, p = 0.001) and corona radiata lesion on diffusion-weighted MRI (100 vs. 69%, p = 0.013) were all more frequent than in the non-PS group.
Bedside neurological assessment and MRI findings may allow us to predict PS and start early intensive treatment for preventing further neurological deterioration.
寻找预测急性腔隙性脑梗死神经功能恶化的神经学或神经影像学征象。
回顾性研究61例幕上腔隙性脑梗死患者，这些患者均在发病48小时内入院。采用美国国立卫生研究院卒中量表的运动评分，将进行性卒中（PS）定义为发病后7天内出现的进行性运动功能缺损。
16例患者（26%）被归入PS组。PS组中，起病波动或进展（81%对42%，p = 0.009）、入院时以腿部为主的运动功能缺损（63%对16%，p = 0.001）以及扩散加权磁共振成像上的放射冠病变（100%对69%，p = 0.013）均比非PS组更常见。
床边神经学评估和磁共振成像结果可能使我们能够预测PS，并开始早期强化治疗以预防进一步的神经功能恶化。
