Infarction location for predicting cerebral infarction progressive motor nerve function deficits in middle cerebral artery area
10.3969/j.issn.1671-8348.2018.06.013
- VernacularTitle:梗死位置预测大脑中动脉区脑梗死进展性运动神经功能损伤
- Author:
Xiaoqi ZHU
1
;
Xuesheng LU
;
Yun ZHANG
;
Ming XU
;
Qianfeng YAN
;
Ji DING
Author Information
1. 上海交通大学医学院附属同仁医院神经内科
- Keywords:
middle cerebral artery infarction;
progressive motor deficits;
internal watershed infarction;
perforating branch atheromatous disease
- From:
Chongqing Medicine
2018;47(6):763-766
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation between the infarction location and progressive motor deficits (PMD) occurrence.Methods The patients with middle cerebral artery(MCA) infarction within 24 h of onset without thrombolytic therapy were included.The National Institutes of Health Stroke Scale(NIHSS) motor item score increase ≥2 points of the base line within 7 d after stroke onset served as the PMD diagnostic criteria.The differences in clinical and laboratory data,and infarction location were compared between the PMD group and non-PMD group.The multivariate Logistic regression analysis predicted the risk factors of PMD occurrence.Results A total 121 patients with MCA acute cerebral infarction were included in the study and divided into the PMD group (45 cases) and non-PMD group (76 cases).The internal watershed infarction occurrencerate in the PMD group was higher than that in the non-PMD group (26.7 ％ vs.5.3％,p=0.001).The occurrence rate of penetrating arterial infarction (PAI) had no statistical difference between the PMD group and non-PMD group(42.2％ vs.35.5％,P=0.463).PAI was further divided into perforating branch atheromatous disease (BAD) and lipohyalinitic degeneration (LD).The occurrence rate of BAD in the PMD group was significantly higher than that in the non-PMD group (28.9％ vs.9.2％,P=0.005).The stepwise Logistic regression analysis indicated that watershed infarction [odds ratio (OR):9.750,95 ％ confidence interval(CI):2.828-33.612,P=0.000] and BAD lesion (OR:6.036,95 ％ CI:2.119-17.190,P =0.001) were the independent risk factors contributing to PMD.Conclusion Internal watershed infarction and BAD lesion may predict the PMD occurrence.The infarct location is conducive to find the high risk population of cerebral infarction progress.
