Lenticulostriate artery involvement is predictive of poor outcomes in superficial middle cerebral artery territory infarction

Kijeong Lee, Eun Hye Kim, Dongbeom Song, Young Dae Kim, Hyo Suk Nam, Hye Sun Lee, Jihoe Heo

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Abstract

Purpose: Patients with superficial middle cerebral artery (MCA) territory infarction may have concomitant lenticulostriate artery (LSA) territory infarction. We investigated the mechanisms thereof and the outcomes of patients with superficial MCA territory infarction according to the presence or absence of LSA involvement. Materials and Methods: Consecutive patients with first-ever infarction in the unilateral superficial MCA territory were included in this study. They were divided into the superficial MCA only (SM) group and the superficial MCA plus LSA (SM+L) group. Results: Of the 398 patients, 84 patients (21.1%) had LSA involvement (SM+L group). The SM+L group more frequently had significant stenosis of the proximal MCA or carotid artery and high-risk cardioembolic sources. Stroke severity and outcomes were remarkably different between the groups. The SM+L group showed more severe neurologic deficits (National Institute of Health Stroke Scale score 10.8±7.1 vs. 4.0±5.0, p<0.001) and larger infarct in the superficial MCA territory (40.8±62.6 cm 3 vs. 10.8±21.8 cm 3 , p<0.001) than the SM group. A poor functional outcome (mRS >2) at 3 months was more common in the SM+L group (64.3% vs. 15.9%, p<0.001). During a mean follow-up of 26 months, 67 patients died. All-cause (hazard ratio, 2.246) and stroke (hazard ratio, 9.193) mortalities were higher in the SM+L group than the SM group. In multivariate analyses, LSA involvement was an independent predictor of poor functional outcomes and stroke mortality. Conclusion: LSA territory involvement is predictive of poor long-term outcomes in patients with superficial MCA territory infarction.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalYonsei medical journal
Volume58
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Middle Cerebral Artery Infarction
Middle Cerebral Artery
Arteries
Stroke
Infarction
Mortality
National Institutes of Health (U.S.)
Neurologic Manifestations
Carotid Arteries
Pathologic Constriction
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, Kijeong ; Kim, Eun Hye ; Song, Dongbeom ; Kim, Young Dae ; Nam, Hyo Suk ; Lee, Hye Sun ; Heo, Jihoe. / Lenticulostriate artery involvement is predictive of poor outcomes in superficial middle cerebral artery territory infarction. In: Yonsei medical journal. 2017 ; Vol. 58, No. 1. pp. 123-130.
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abstract = "Purpose: Patients with superficial middle cerebral artery (MCA) territory infarction may have concomitant lenticulostriate artery (LSA) territory infarction. We investigated the mechanisms thereof and the outcomes of patients with superficial MCA territory infarction according to the presence or absence of LSA involvement. Materials and Methods: Consecutive patients with first-ever infarction in the unilateral superficial MCA territory were included in this study. They were divided into the superficial MCA only (SM) group and the superficial MCA plus LSA (SM+L) group. Results: Of the 398 patients, 84 patients (21.1{\%}) had LSA involvement (SM+L group). The SM+L group more frequently had significant stenosis of the proximal MCA or carotid artery and high-risk cardioembolic sources. Stroke severity and outcomes were remarkably different between the groups. The SM+L group showed more severe neurologic deficits (National Institute of Health Stroke Scale score 10.8±7.1 vs. 4.0±5.0, p<0.001) and larger infarct in the superficial MCA territory (40.8±62.6 cm 3 vs. 10.8±21.8 cm 3 , p<0.001) than the SM group. A poor functional outcome (mRS >2) at 3 months was more common in the SM+L group (64.3{\%} vs. 15.9{\%}, p<0.001). During a mean follow-up of 26 months, 67 patients died. All-cause (hazard ratio, 2.246) and stroke (hazard ratio, 9.193) mortalities were higher in the SM+L group than the SM group. In multivariate analyses, LSA involvement was an independent predictor of poor functional outcomes and stroke mortality. Conclusion: LSA territory involvement is predictive of poor long-term outcomes in patients with superficial MCA territory infarction.",
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Lenticulostriate artery involvement is predictive of poor outcomes in superficial middle cerebral artery territory infarction. / Lee, Kijeong; Kim, Eun Hye; Song, Dongbeom; Kim, Young Dae; Nam, Hyo Suk; Lee, Hye Sun; Heo, Jihoe.

In: Yonsei medical journal, Vol. 58, No. 1, 01.01.2017, p. 123-130.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lenticulostriate artery involvement is predictive of poor outcomes in superficial middle cerebral artery territory infarction

AU - Lee, Kijeong

AU - Kim, Eun Hye

AU - Song, Dongbeom

AU - Kim, Young Dae

AU - Nam, Hyo Suk

AU - Lee, Hye Sun

AU - Heo, Jihoe

PY - 2017/1/1

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N2 - Purpose: Patients with superficial middle cerebral artery (MCA) territory infarction may have concomitant lenticulostriate artery (LSA) territory infarction. We investigated the mechanisms thereof and the outcomes of patients with superficial MCA territory infarction according to the presence or absence of LSA involvement. Materials and Methods: Consecutive patients with first-ever infarction in the unilateral superficial MCA territory were included in this study. They were divided into the superficial MCA only (SM) group and the superficial MCA plus LSA (SM+L) group. Results: Of the 398 patients, 84 patients (21.1%) had LSA involvement (SM+L group). The SM+L group more frequently had significant stenosis of the proximal MCA or carotid artery and high-risk cardioembolic sources. Stroke severity and outcomes were remarkably different between the groups. The SM+L group showed more severe neurologic deficits (National Institute of Health Stroke Scale score 10.8±7.1 vs. 4.0±5.0, p<0.001) and larger infarct in the superficial MCA territory (40.8±62.6 cm 3 vs. 10.8±21.8 cm 3 , p<0.001) than the SM group. A poor functional outcome (mRS >2) at 3 months was more common in the SM+L group (64.3% vs. 15.9%, p<0.001). During a mean follow-up of 26 months, 67 patients died. All-cause (hazard ratio, 2.246) and stroke (hazard ratio, 9.193) mortalities were higher in the SM+L group than the SM group. In multivariate analyses, LSA involvement was an independent predictor of poor functional outcomes and stroke mortality. Conclusion: LSA territory involvement is predictive of poor long-term outcomes in patients with superficial MCA territory infarction.

AB - Purpose: Patients with superficial middle cerebral artery (MCA) territory infarction may have concomitant lenticulostriate artery (LSA) territory infarction. We investigated the mechanisms thereof and the outcomes of patients with superficial MCA territory infarction according to the presence or absence of LSA involvement. Materials and Methods: Consecutive patients with first-ever infarction in the unilateral superficial MCA territory were included in this study. They were divided into the superficial MCA only (SM) group and the superficial MCA plus LSA (SM+L) group. Results: Of the 398 patients, 84 patients (21.1%) had LSA involvement (SM+L group). The SM+L group more frequently had significant stenosis of the proximal MCA or carotid artery and high-risk cardioembolic sources. Stroke severity and outcomes were remarkably different between the groups. The SM+L group showed more severe neurologic deficits (National Institute of Health Stroke Scale score 10.8±7.1 vs. 4.0±5.0, p<0.001) and larger infarct in the superficial MCA territory (40.8±62.6 cm 3 vs. 10.8±21.8 cm 3 , p<0.001) than the SM group. A poor functional outcome (mRS >2) at 3 months was more common in the SM+L group (64.3% vs. 15.9%, p<0.001). During a mean follow-up of 26 months, 67 patients died. All-cause (hazard ratio, 2.246) and stroke (hazard ratio, 9.193) mortalities were higher in the SM+L group than the SM group. In multivariate analyses, LSA involvement was an independent predictor of poor functional outcomes and stroke mortality. Conclusion: LSA territory involvement is predictive of poor long-term outcomes in patients with superficial MCA territory infarction.

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