J Korean Neurol Assoc > Volume 21(4); 2003 > Article

Journal of the Korean Neurological Association 2003;21(4): 339-345.

열공성 증후군 환자에서 모동맥 협착의 예후적 의의

주성렬 , 오세호 이재혁 허광기 방오영 허균

아주대학교 의과대학 신경과학교실

"Prognostic Value of Parent Arterial Lesions in the Patients with Lacunar Syndrome"

Sung-Yeol Joo

Department of Neurology, College of Medicine, Ajou University

Abstract

"Background: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled.
Methods: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups.
Results: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). C o n c l u s I o n s: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.Key Words: Infarction/Lacunar, Prognosis, Recurrence"