Clinical Characteristics and Outcome of Patients with Lacunar Infarcts and Concurrent Embolic Ischemic Lesions
Standard
Clinical Characteristics and Outcome of Patients with Lacunar Infarcts and Concurrent Embolic Ischemic Lesions. / Barow, Ewgenia; Boutitie, Florent; Cheng, Bastian; Cho, Tae-Hee; Ebinger, Martin; Endres, Matthias; Fiebach, Jochen B; Fiehler, Jens; Ford, Ian; Galinovic, Ivana; Nickel, Alina; Puig, Josep; Roy, Pascal; Wouters, Anke; Thijs, Vincent; Lemmens, Robin; Muir, Keith W; Nighoghossian, Norbert; Pedraza, Salvador; Simonsen, Claus Z; Gerloff, Christian; Thomalla, Götz; WAKE-UP Investigators.
in: CLIN NEURORADIOL, Jahrgang 30, Nr. 3, 09.2020, S. 511-516.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Clinical Characteristics and Outcome of Patients with Lacunar Infarcts and Concurrent Embolic Ischemic Lesions
AU - Barow, Ewgenia
AU - Boutitie, Florent
AU - Cheng, Bastian
AU - Cho, Tae-Hee
AU - Ebinger, Martin
AU - Endres, Matthias
AU - Fiebach, Jochen B
AU - Fiehler, Jens
AU - Ford, Ian
AU - Galinovic, Ivana
AU - Nickel, Alina
AU - Puig, Josep
AU - Roy, Pascal
AU - Wouters, Anke
AU - Thijs, Vincent
AU - Lemmens, Robin
AU - Muir, Keith W
AU - Nighoghossian, Norbert
AU - Pedraza, Salvador
AU - Simonsen, Claus Z
AU - Gerloff, Christian
AU - Thomalla, Götz
AU - WAKE-UP Investigators
PY - 2020/9
Y1 - 2020/9
N2 - PURPOSE: Lacunar infarcts are thought to result from occlusion of small penetrating arteries due to microatheroma and lipohyalinosis, pathognomonic for cerebral small vessel disease (CSVD). Concurrent embolic ischemic lesions indicate a different stroke mechanism. The purpose of this study was to examine the clinical characteristics and outcome of patients with lacunar infarcts and concurrent embolic infarcts on diffusion-weighted imaging (DWI).METHODS: All patients screened for the WAKE-UP trial (ClinicalTrials.gov number, NCT01525290) were reviewed for acute lacunar infarcts and concurrent embolic lesions on baseline DWI. Clinical characteristics and outcome were compared between lacunar infarct patients with and without concurrent embolic lesions.RESULTS: Of 244 patients with an acute lacunar infarct, 20 (8.2%) had concurrent acute embolic infarcts. Compared to patients with a lacunar infarct only, patients with concurrent embolic infarcts were older (mean age 69 years vs. 63 years; p = 0.031), more severely affected (median National Institutes of Health Stroke Scale [NIHSS] score 5 vs. 4; p = 0.046), and-among those randomized-had worse functional outcome at 90 days (median modified Rankin Scale [mRS] 3 vs. 1; p = 0.011).CONCLUSION: Approximately 8% of lacunar infarct patients show concurrent embolic lesions suggesting a stroke etiology other than CSVD. These patients are more severely affected and have a worse functional outcome illustrating the need for a thorough diagnostic work-up of possible embolic sources even in patients with an imaging-defined diagnosis of lacunar infarcts.
AB - PURPOSE: Lacunar infarcts are thought to result from occlusion of small penetrating arteries due to microatheroma and lipohyalinosis, pathognomonic for cerebral small vessel disease (CSVD). Concurrent embolic ischemic lesions indicate a different stroke mechanism. The purpose of this study was to examine the clinical characteristics and outcome of patients with lacunar infarcts and concurrent embolic infarcts on diffusion-weighted imaging (DWI).METHODS: All patients screened for the WAKE-UP trial (ClinicalTrials.gov number, NCT01525290) were reviewed for acute lacunar infarcts and concurrent embolic lesions on baseline DWI. Clinical characteristics and outcome were compared between lacunar infarct patients with and without concurrent embolic lesions.RESULTS: Of 244 patients with an acute lacunar infarct, 20 (8.2%) had concurrent acute embolic infarcts. Compared to patients with a lacunar infarct only, patients with concurrent embolic infarcts were older (mean age 69 years vs. 63 years; p = 0.031), more severely affected (median National Institutes of Health Stroke Scale [NIHSS] score 5 vs. 4; p = 0.046), and-among those randomized-had worse functional outcome at 90 days (median modified Rankin Scale [mRS] 3 vs. 1; p = 0.011).CONCLUSION: Approximately 8% of lacunar infarct patients show concurrent embolic lesions suggesting a stroke etiology other than CSVD. These patients are more severely affected and have a worse functional outcome illustrating the need for a thorough diagnostic work-up of possible embolic sources even in patients with an imaging-defined diagnosis of lacunar infarcts.
U2 - 10.1007/s00062-019-00800-5
DO - 10.1007/s00062-019-00800-5
M3 - SCORING: Journal article
C2 - 31161343
VL - 30
SP - 511
EP - 516
JO - CLIN NEURORADIOL
JF - CLIN NEURORADIOL
SN - 1869-1439
IS - 3
ER -