Isolated anterior cerebral artery territory infarction: etiology, clinical features, and outcome
10.3760/cma.j.issn.1673-4165.2024.06.003
- VernacularTitle:孤立性大脑前动脉供血区梗死：病因学、临床特征和转归
- Author:
Guangsheng WANG
1
;
Junjie BAO
;
Ting HU
;
Yuanyuan TIAN
;
Li HUANG
Author Information
1. 徐州医科大学附属沭阳医院神经内科，宿迁 223600
- Keywords:
Ischemic stroke;
Anterior cerebral artery;
Infarction, anterior cerebral artery;
Magnetic resonance imaging;
Treatment outcome
- From:
International Journal of Cerebrovascular Diseases
2024;32(6):414-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the etiology, clinical features and outcome of isolated anterior cerebral artery (ACA) territory infarction.Methods:Patients with isolated ACA territory infarction admitted to the Affiliated Shuyang Hospital of Xuzhou Medical University from April 2019 to December 2023 were retrospectively included. The demographic and clinical data were collected. The etiology subtypes of stroke were divided into large artery atherosclerosis (LAA), cardioembolism (CE), small vessel occlusion (SVO), stroke of other determined etiology (SOE), and stroke of undetermined etiology (SUE). At 90 days after onset, the modified Rankin Scale was used to evaluate the outcome. 0~2 points were defined as good outcome, and >2 points were defined as poor outcome. Multivariate logistic regression analysis was used to identify independent risk factors for poor outcomes. Results:A total of 67 patients with isolated ACA territory infarction were enrolled, including 31 males (46.27%), aged 67.20±12.59 years. There were 26 patients (38.81%) of LAA type, 10 (14.93%) of CE type, 7 (10.45%) of SVO type, 12 (17.91%) of SOE type, and 12 (17.91%) of SUE type. Fifty-two patients (77.61%) had good outcome, while 15 (22.39%) had poor outcome. There were significant differences in gender, diabetes, atrial fibrillation, antithrombin-Ⅲ activity, urinary incontinence, cognitive impairment, and the baseline National Institutes of Health Stroke Scale (NIHSS) score among different etiological subtypes (all P<0.05). Multivariate logistic regression analysis showed that previous stroke history (odds ratio 17.995, 95% confidence interval 1.276-253.852; P=0.032) and high baseline NIHSS score (odds ratio 2.094, 95% confidence interval 1.333-3.292; P=0.001) were the independent risk factors for poor outcome. Conclusions:The most common etiology of isolated ACA territory infarction is LAA, and most patients have good outcome. Previous stroke history and high baseline NIHSS score are the independent risk factors for poor outcome.
