梗死部位可预测大脑中动脉供血区内单个小的皮质下梗死的预后。

The infarct location predicts the outcome of single small subcortical infarction in the territory of the middle cerebral artery.

作者信息

Yang Xiaomeng, Pu Yuehua, Liu Liping, Wang Yilong, Zou Xinying, Pan Yuesong, Wang Defeng, Zhao Xingquan, Wong Ka S, Wang Yongjun

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, China.

出版信息

J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1676-81. doi: 10.1016/j.jstrokecerebrovasdis.2014.01.019. Epub 2014 Apr 13.

DOI:10.1016/j.jstrokecerebrovasdis.2014.01.019

PMID:24739591

Abstract

BACKGROUND

Single small subcortical infarction (SSSI) in the territory of the middle cerebral artery (MCA) may be classified as proximal SSSI (pSSSI) or distal SSSI (dSSSI) according to its extension to the MCA. We sought to investigate the outcome of different types of SSSIs.

METHODS

We assessed 177 patients who had an SSSI (67 pSSSI and 110 dSSSI) in the perforator territory of MCA. The clinical characteristics, neurologic status (initial National Institutes of Health Stroke Scale score at admission and modified Rankin Scale [mRS] score at 1 year), and clinical treatments at 1 year were evaluated.

RESULTS

Among the 177 patients, 130 had favorable (mRS score≤1) and 41 had unfavorable outcome (mRS score≥2) at 1 year, dSSSI had higher mRS than pSSSI at 1 year (1 [0-2] versus 0 [0-1]; P=.013). The age (odds ratio [OR] 1.049, 95% confidence interval [CI] 1.002-1.098; P=.041) and distal location of the lesion (OR 2.687, 95% CI 1.039-6.948; P=.042) were found to be independent risk factors of 1-year unfavorable outcome of SSSIs.

CONCLUSIONS

SSSI has a heterogeneous outcome at 1 year according to the lesion location.

摘要

背景

大脑中动脉（MCA）供血区域的单个小皮质下梗死（SSSI）可根据其在MCA上的延伸范围分为近端SSSI（pSSSI）或远端SSSI（dSSSI）。我们旨在研究不同类型SSSI的预后情况。

方法

我们评估了177例在MCA穿支供血区域发生SSSI的患者（67例pSSSI和110例dSSSI）。评估了患者的临床特征、神经功能状态（入院时的初始美国国立卫生研究院卒中量表评分和1年时的改良Rankin量表[mRS]评分）以及1年时的临床治疗情况。

结果

在这177例患者中，130例在1年时预后良好（mRS评分≤1），41例预后不良（mRS评分≥2），dSSSI在1年时的mRS评分高于pSSSI（1[0 - 2]对0[0 - 1]；P = 0.013）。发现年龄（优势比[OR]1.049，95%置信区间[CI]1.002 - 1.098；P = 0.041）和病变的远端位置（OR 2.687，95%CI 1.039 - 6.948；P = 0.042）是SSSI 1年预后不良的独立危险因素。