Clinical, imaging features and outcome in internal carotid artery versus middle cerebral artery disease
First author:Changqing Zhang
Corresponding author:Yongjun Wang
2019-12-05
Journal:PLos One
Publication type: Original Contributions
IF(IF): 3.24
PMID: 31805111 Link To Pubmed Full text Download
大脑中动脉病变所致的脑梗死更多见于亚洲人群,而颈内动脉病变所致的脑梗死更多见于西方人。文献报道,韩国颈内动脉和大脑中动脉分布区脑梗死患者的临床和影像学表现存在显著差异,本研究的主要目的是比较国人颈内动脉和大脑中动脉分布区脑梗死的危险因素、临床和影像学表现以及预后有何差异。
We prospectively enrolled 1172 patients with noncardiogenic ischemic stroke in ipsilateral ICA or MCA territory. Clinical, neuroradiologic and outcome of the two groups were compared in this observational cohort study.
The clinical, radiologic characteristics and outcome are distinctively different between ICA and MCA disease. Compared to MCA disease, ICA disease has more serious clinical and radiologic manifestation, and poorer outcome.
The ICA group more frequently presented with decreased alertness, gaze palsy, aphasia, and neglect than the MCA group at admission, and more often had higher National Institute of Health stroke scale score at admission and discharge. Meanwhile, the ICA group more frequently had multiple acute infarcts, watershed infarcts, territorial infarct, small cortical infarct, and responsible artery stenosis ≥70%. Whereas penetrating artery infarct and parent artery occluding penetrating artery was more often associated with MCA disease. The ICA group more frequently had inhospital complications of pneumonia and deep vein thrombosis, more often had disability at discharge, and had more recurrent ischemic stroke or transient ischemic attack in 1 Year. Multivariable logistic regression identified male (OR, 1.99; 95% CI, 1.30 to 3.05; P = 0.002), history of coronary heart disease (OR, 1.85; 95% CI, 1.03 to 3.32; P = 0.041), multiple acute infarcts (OR, 4.18; 95% CI, 2.07 to 8.45; P<0.0001), and territorial infarct (OR, 2.23; 95% CI, 1.52 to 3.27; P<0.0001) was more often associated with ICA territory disease.