Large subcortical infarcts: clinical features, risk factors, and long-term prognosis compared with cortical and small deep infarcts
BACKGROUND AND PURPOSE: In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts. METHODS: Patients with a transient or minor ischemic attack (modified Rankin Scale grade of < or =3) who had a single relevant supratentorial infarct of presumed noncardioembolic origin on CT were classified as suffering from a large subcortical (n=120), small deep (n=324), or cortical (n=211) infarct. Mean follow-up was 8 years. Rates of recurrent stroke were compared with Cox regression. RESULTS: The clinical deficits caused by large subcortical infarcts resembled either those of a cortical or those of a small deep infarct. Risk factor profiles were similar in the 3 groups. The rate of recurrent stroke in patients with a large subcortical infarct (25/120; 21%) did not differ from that of patients with a cortical infarct (46/211; 22%) or with a small deep infarct (60/324; 19%). After adjustment for age, sex, and vascular risk factors, hazard ratios for recurrent stroke of large subcortical and cortical infarcts were 1.05 (95% CI, 0.65 to 1.70) and 1.17 (95% CI, 0.79 to 1.73), respectively, compared with small deep infarcts. CONCLUSIONS: Clinical features, risk factor profiles, and stroke recurrence rate in patients with a large subcortical infarct only differ slightly from those in patients with small deep or cortical infarcts.
|Keywords||Adult, Aged, Aged, 80 and over, Aspirin/therapeutic use, Brain/*blood supply, Cerebral Cortex/*blood supply, Cerebral Infarction/*classification/epidemiology/pathology, Cohort Studies, Female, Follow-Up Studies, Humans, Ischemic Attack, Transient/complications/drug therapy, Male, Middle Aged, Multicenter Studies as Topic/statistics & numerical data, Netherlands, Platelet Aggregation Inhibitors/therapeutic use, Prognosis, Proportional Hazards Models, Randomized Controlled Trials as Topic/statistics & numerical data, Recurrence, Risk Factors, classification, epidemiology, stroke, ischemic|
|Persistent URL||dx.doi.org/10.1161/01.STR.0000226993.88307.ff, hdl.handle.net/1765/22468|
Halkes, P.H.A., Kappelle, L.J., van Gijn, J., van Wijk, I., Koudstaal, P.J., & Algra, A.. (2006). Large subcortical infarcts: clinical features, risk factors, and long-term prognosis compared with cortical and small deep infarcts. Stroke, 37(7), 1828–1832. doi:10.1161/01.STR.0000226993.88307.ff