Clinical,imaging features and long-term outcomes in isolated anterior cerebral artery territory infarction:comparison of atherosclerotic stroke and non-atherosclerotic stroke
10.3760/cma.j.issn.1673-4165.2017.10.003
- VernacularTitle:单纯大脑前动脉供血区梗死的临床、影像学特征和远期转归:动脉粥样硬化与非动脉粥样硬化性卒中的比较
- Author:
Shuanggen ZHU
1
;
Hongbing CHEN
;
Shujin TANG
;
Wenjin SHANG
;
Aiwu ZHANG
;
Wusheng ZHU
Author Information
1. 518109,深圳市龙华区人民医院神经内科
- Keywords:
Stroke;
Brain Ischemia;
Infarction;
Anterior Cerebral Artery;
Intracranial Arteriosclerosis;
Magnetic Resonance Imaging;
Magnetic Resonance Angiography;
Prognosis;
Recurrence
- From:
International Journal of Cerebrovascular Diseases
2017;25(10):885-893
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical, imaging features, and long-term outcomes in patients with isolated anterior cerebral artery (ACA) territory infarction due to ACA atherosclerosis, and compare with isolated ACA territory infarction due to other etiologies. Methods The consecutive patients with acute isolated ACA territory infarction confirmed by diffusion-weighted imaging were enrolled prospectively. According to their stroke etiology, they were divided into ACA atherosclerotic stroke and non-ACA atherosclerotic stroke. The infarction patterns were classified as single infarction including perforating artery infarction (PAI), small branch infarction (SBI) and cortical branch infarction(CBI), and multiple infarctions (a combination of PAI,SBI or CBI).The clinical,imaging features and long-term outcomes were compared between the ACA atherosclerotic stroke group and the non-ACA atherosclerotic stroke group. Results A total of 86 patients (47 males) were enrolled, ages ranging from 39 to 88 years (mean 67.5 ± 12.5 years). There were 56 patients in the ACA atherosclerotic stroke group, and 30 patients in the non-ACA atherosclerotic stroke group (12 carotid atherosclerosis, 6 cardioembolism, 2 internal carotid artery dissection, 10 undetermined etiology). The proportions of females (53.6% vs. 30.0%; P= 0.043), progressive onset of stroke(58.9% vs. 20.0%;P=0.001),SBI alone(21.4% vs. 3.3%;P=0.029)and infarction involving small branches(80.4% vs. 46.7%;P=0.001)in the ACA atherosclerotic stroke group were higher than those in the non-ACA atherosclerotic stroke group, and CBI alone (17.9% vs. 55.3%, P=0.001) was lower. The follow-up times in the ACA atherosclerotic stroke group and the non-ACA atherosclerotic stroke group were 29.8 ± 16.5 months and 30.4 ± 18.5 months, respectively (P=0.534). Five-year cumulative incidence of adverse events (stroke, cardiovascular events and death) in the ACA atherosclerotic stroke group and the non-ACA atherosclerotic stroke group were 36.3% and 69.9% respectively(log rank test,P=0.021).Conclusions ACA atherosclerosis is the common etiology for isolated ACA territory infarction. The isolated ACA territory infarction due to ACA atherosclerosis had distinctive infarction patterns and a lower long-term incidence of adverse events compared with those due to non-ACA atherosclerosis.
