Clinical, imaging features and outcome in internal carotid artery versus middle cerebral artery disease


Autoři: Changqing Zhang aff001;  Yilong Wang aff001;  Xingquan Zhao aff001;  Liping Liu aff001;  ChunXue Wang aff001;  Zixiao Li aff001;  Yuehua Pu aff001;  Xinying Zou aff001;  Yuesong Pan aff002;  Yongjun Wang aff001
Působiště autorů: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China aff001;  China National Clinical Research Center for Neurological Diseases, Beijing, China aff002;  Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China aff003;  Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0225906

Souhrn

Background

Only a very few studies had compared the differences in topographic patterns of cerebral infarcts between middle cerebral artery (MCA) and internal carotid artery (ICA) disease. Besides, the comparison of clinical features and outcomes between MCA and ICA disease had rarely been reported.

Objectives

To compare the clinical, imaging features and outcome of MCA versus ICA disease.

Methods

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.

Results

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.

Conclusions

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.

Klíčová slova:

Arteries – Carotid arteries – Cerebral arteries – Coronary heart disease – Ischemic stroke – Magnetic resonance imaging – Stenosis – stroke


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Článok vyšiel v časopise

PLOS One


2019 Číslo 12