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European Radiology
Published in: European Radiology 3/2017

01-03-2017 | Ultrasound

Increased arterial pulsatility and progression of single subcortical infarction

Authors: Keon-Joo Lee, Keun-Hwa Jung, Chan-Young Park, Jeong-Min Kim, Soon-Tae Lee, Kon Chu, Manho Kim, Sang Kun Lee, Jae-Kyu Roh

Published in: European Radiology | Issue 3/2017

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Abstract

Objective

We investigated the association of clinical, laboratory, sonographic and imaging parameters, in the progression of single subcortical infarctions.

Methods

Consecutive 169 patients with lacunar (n = 89) and striatocapsular infarctions (n = 80) in the middle cerebral artery (MCA) territory with nonstenotic MCAs were recruited and examined for stroke progression. The pulsatility index (PI) was measured by transcranial Doppler from ipsilateral M1.

Results

The striatocapsular infarction group exhibited more stroke progression. The patients with progressive lacunar infarctions had more diabetes, higher HbA1c levels, and higher initial National Institutes of Health Stroke Scale (NIHSS) scores, and the patients with progressive striatocapsular infarctions had more hypertension, higher cholesterol levels, and higher NIHSS scores. The MCA PI was higher in the lacunar infarction patients with progression (0.99 ± 0.19 vs. 0.90 ± 0.14, p = 0.048), while the striatocapsular infarction patients did not differ according to progression. From a multivariate analysis, higher MCA PI were independently associated with lacunar infarction progression (by 0.1 increase, OR 1.51; 95 % CI 1.06–2.15; p = 0.024).

Conclusions

Higher pulsatility was associated with progression in lacunar infarction. PI measured by transcranial Doppler sonography might reflect downstream arterial resistance and vascular/paravascular perfusion status and be a possible indicator of stroke progression.

Key Points

• Higher pulsatility index was observed in progression group of lacunar infarction patients.
• Higher pulsatility index seemed to be associated with progression in lacunar infarction patients.
• Differences in the factors associated with stroke progression suggest different underlying pathophysiologies.
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Metadata
Title
Increased arterial pulsatility and progression of single subcortical infarction
Authors
Keon-Joo Lee
Keun-Hwa Jung
Chan-Young Park
Jeong-Min Kim
Soon-Tae Lee
Kon Chu
Manho Kim
Sang Kun Lee
Jae-Kyu Roh
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4486-0

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