Analysis of acute multiple brain infarction using diffusion-weighted MR imaging.

典子, 松本; 千晶, 横田; 泰弘, 長谷川; 武典, 山口; 一夫, 峰松

doi:10.3995/jstroke.23.248

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Several previous studies indicated that the frequency of CE was clearly high in the patients with the large cerebral infarction [4,5,7,13,14]. It was also reported that LAA was associated with the small ischemic lesions [5,14,15,16,17]. However, few previous studies are available to explain the differences of the infarct size between LAA and CE.…”

Section: Discussionmentioning

confidence: 72%

Estimation of Stroke Etiology from Lesion Patterns on Diffusion-Weighted Magnetic Resonance Imaging in Patients with Carotid Artery Occlusive Disease

Oyama

Moriwaki²,

Yamada

et al. 2012

Eur Neurol

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Background: Various mechanisms can be considered in ischemic stroke with internal carotid artery (ICA) occlusive diseases. We clarified the etiologic mechanisms from lesion patterns on diffusion-weighted imaging (DWI). Methods: One hundred and twenty consecutive ischemic stroke patients with ipsilateral ICA occlusive diseases were enrolled and classified into 3 groups according to the size of DWI lesions: group A, massive; group B, moderate-to-large; and group C, small. Group C was divided into 3 subgroups according to the number of lesions: C1, 1–3; C2, 4–9; and C3, 10 or more. The relationship between the DWI findings and stroke subtypes according to the TOAST classification was investigated. Results: Cardioembolism was significantly more common in groups A and B than in group C, while large-artery atherosclerosis (LAA) was more frequent in group C than in groups A and B. In group A, cardioembolism accounted for 32%, while LAA was not observed. Statistical analyses showed trends toward a higher frequency of LAA in groups C2 and C3 than in group C1. Conclusions: Mechanisms of acute stroke in ICA diseases can be simply assessed from the lesion size and number, which may be useful in considering acute therapeutic strategies.

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Section: Discussionmentioning

confidence: 72%

Estimation of Stroke Etiology from Lesion Patterns on Diffusion-Weighted Magnetic Resonance Imaging in Patients with Carotid Artery Occlusive Disease

Oyama

Moriwaki²,

Yamada

et al. 2012

Eur Neurol

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“…[12][13][14][15][16][17][18] Of these, only three studies [12][13][14] have full reports and the rest were published as abstracts. [15][16][17][18] The first of the full reports 12 looked specifically at carotid stenosis and ipsilateral multiple acute lacunar infarctions and used brain CT to document acute lacunar infarctions. However, CT is much less sensitive and specific than DWI for both acute and established subcortical infarction, and is less able to age the infarct than combined MRI sequences.…”

Section: Discussionmentioning

confidence: 99%

“…11 Recently, there have been several reports of patients with multiple acute small subcortical infarcts seen on DWI. [12][13][14][15][16][17][18] The multiplicity of the lesions occurring apparently simultaneously in different deep perforating artery territories has led to the suggestion that embolic mechanisms are a possible aetiology in these cases. 5 12-18 We observed a subgroup of patients presenting with a mild clinical stroke syndrome who were noted to have several hyperintense small subcortical infarcts (one consistent with the presenting symptoms and the others apparently asymptomatic) on DWI ( fig 1A).…”

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confidence: 99%

Are multiple acute small subcortical infarctions caused by embolic mechanisms?

Chowdhury

Wardlaw²,

Dennis³

2004

Journal of Neurology, Neurosurgery & Psychiatry

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Objective: To seek evidence of potential embolic sources or other stroke mechanisms in patients who, on chance observation, had several apparently recent small subcortical infarcts on diffusion weighted magnetic resonance imaging (DWI). Methods: Patients presenting with stroke and multiple hyperintense subcortical infarcts visible on DWI were identified prospectively. Detailed clinical and radiological assessments were done independently and blinded to each other. Results: Of 10 patients with multiple hyperintense subcortical infarcts on DWI, a definite embolic source was identified in only one. Most patients were hypertensive and smoked. The DWI appearance suggested that the subcortical lesions had occurred within several weeks rather than at exactly the same time. Most patients also had significant white matter hyperintensities and four had microhaemorrhages. Conclusions: Embolic sources were not identified in most patients but they did have systemic vascular risk factors and brain imaging features of ''small vessel disease.'' A more generalised intrinsic process affecting many small cerebral vessels contemporaneously could explain multiple acute small subcortical infarcts. White matter hyperintensities, microhaemorrhages, and multiple small subcortical infarcts may share a common pathophysiological mechanism such as a diffuse cerebral microvascular abnormality which requires further exploration.A bout 25% of first ever in a lifetime ischaemic strokes are caused by lacunar or small subcortical infarction.

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Multiple and bihemispheric infarcts

Kumral¹

2012

Stroke Syndromes

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Analysis of acute multiple brain infarction using diffusion-weighted MR imaging.

Cited by 3 publications

References 19 publications

Estimation of Stroke Etiology from Lesion Patterns on Diffusion-Weighted Magnetic Resonance Imaging in Patients with Carotid Artery Occlusive Disease

Estimation of Stroke Etiology from Lesion Patterns on Diffusion-Weighted Magnetic Resonance Imaging in Patients with Carotid Artery Occlusive Disease

Are multiple acute small subcortical infarctions caused by embolic mechanisms?

Multiple and bihemispheric infarcts

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