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J Korean Neurol Assoc. 2012;30(4):267-273.
- Association of 3 Stigmas of Cerebral Microangiopathy With Early
Neurological Deterioration in Lacunar Infarction
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Jangsup Moon
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Department of Neurology, Stroke Center, Seoul National University Bundang Hospital, Seoul National University College
of Medicine, Seongnam, Korea
- 뇌미세혈관병증 3가지 표식과 열공뇌경색 초기 신경학적
악화와의 관련성
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문장섭, 김나영 강지훈 양미화 장명숙 한문구 배희준
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서울대학교 의과대학 신경과학교실, 분당서울대학교병원 뇌졸중센터 신경과
- Abstract
- Background
Neurological deterioration following acute lacunar infarction is not uncommon. Its association with poor
clinical outcome is well-known, but little is known about what causes it. This study aimed to elucidate whether 3 stigmas
of cerebral microangiopathy, a pathogenesis of lacunar infarction, are associated with neurological deterioration in
patients with acute lacunar infarction.
Methods
Patients with acute lacunar infarction who were admitted within 24 hours of onset were identified using a
prospective stroke registry. Patients who presented neurological deterioration within 7 days of hospitalization
(progressive lacune group) were matched to 4 controls (non-progressive lacune group) for ‘onset to arrival time’. Three
stigmas of cerebral microangiopathy (leukoaraiosis, cerebral microbleeds, and silent lacunes) were measured using
initial brain MRI, and their associations with neurological deterioration were analyzed.
Results
During 45 months, a total of 23 patients were identified and matched to 80 controls. Simple comparison of 2
groups showed that those 3 stigmas of cerebral microangiopathy were not significantly associated with neurological
deterioration. Hyperlipidemia (p=0.18), history of transient ischemic attack or stroke (p=0.01), initial NIH stroke scale
(p=0.07), white blood cell counts (p=0.16), and lesion volume (p=0.03) were possibly different (p’s<0.2) between 2 groups.
Multivariable logistic regression analysis did not reveal any significant association of those 3 stigmas with neurological
deterioration, too (all p values>0.5).
Conclusions
This study did not find a relationship between cerebral microangiopathy and neurological deterioration
following acute lacunar infarction. The possibility of inadequate power should be noted. Key Words: Cerebral microangiopathy, Cerebral small vessel disease, Lacunar infarction, Neurological deterioration,
Progressive stroke
Keywords :
- 초록
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