Skip to main content
Top
Published in: BMC Neurology 1/2011

Open Access 01-12-2011 | Research article

Long-term prognosis of symptomatic isolated middle cerebral artery disease in Korean stroke patients

Authors: Mi Sun Oh, Kyung-Ho Yu, Min-Kyung Chu, Hyeo-Il Ma, Yun Joong Kim, Joo Yong Kim, Byung-Chul Lee

Published in: BMC Neurology | Issue 1/2011

Login to get access

Abstract

Background

This study aimed to investigate the long-term mortality and recurrence rate of stroke in first-time stroke patients with symptomatic isolated middle cerebral artery disease (MCAD) under medical management.

Methods

We identified 141 first ever stroke patients (mean age, 64.4 ± 12.5 years; 53% male) with symptomatic isolated MCAD. MCAD was defined as significant stenosis of more than 50% or occlusion of the MCA as revealed by MR angiography. The median follow-up was 27.7 months. We determined a cumulative rate of stroke recurrence and mortality by Kaplan-Meier survival analyses and sought predictors using the Cox proportional hazard model.

Results

The cumulative composite outcome rate (stroke recurrence or any-cause death) was 14%, 19%, 22%, and 28% at years 1, 2, 3, and 5, respectively. The annual recurrence rate of stroke was 4.1%. The presence of diabetes mellitus was the only significant independent predictor of stroke recurrence or any cause of death in multivariate analyses of Cox proportional hazard model adjusted for any plausible potential confounding factors.

Conclusions

We estimated the long-term prognosis of stroke patients with isolated symptomatic MCAD under current medical management in Korea. Diabetes mellitus was found to be a significant predictor for stroke recurrence and mortality.
Appendix
Available only for authorised users
Literature
1.
go back to reference Schumacher HC, Khaw AV, Meyers PM, Gupta R, Higashida RT: Intracranial angioplasty and stent placement for cerebral atherosclerosis. J Vasc Interv Radiol. 2004, 15: 123-132.CrossRef Schumacher HC, Khaw AV, Meyers PM, Gupta R, Higashida RT: Intracranial angioplasty and stent placement for cerebral atherosclerosis. J Vasc Interv Radiol. 2004, 15: 123-132.CrossRef
2.
go back to reference Arenillas JF: Intracranial Atherosclerosis: Current Concepts. Stroke. 2011, 42: S20-23. 10.1161/STROKEAHA.110.597278.CrossRefPubMed Arenillas JF: Intracranial Atherosclerosis: Current Concepts. Stroke. 2011, 42: S20-23. 10.1161/STROKEAHA.110.597278.CrossRefPubMed
3.
go back to reference Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw J-J, Amarenco P: Autopsy Prevalence of Intracranial Atherosclerosis in Patients With Fatal Stroke. Stroke. 2008, 39: 1142-1147. 10.1161/STROKEAHA.107.496513.CrossRefPubMed Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw J-J, Amarenco P: Autopsy Prevalence of Intracranial Atherosclerosis in Patients With Fatal Stroke. Stroke. 2008, 39: 1142-1147. 10.1161/STROKEAHA.107.496513.CrossRefPubMed
4.
go back to reference Wong KS, Huang YN, Gao S, Lam WW, Chan YL, Kay R: Intracranial stenosis in Chinese patients with acute stroke. Neurology. 1998, 50: 812-813.CrossRefPubMed Wong KS, Huang YN, Gao S, Lam WW, Chan YL, Kay R: Intracranial stenosis in Chinese patients with acute stroke. Neurology. 1998, 50: 812-813.CrossRefPubMed
5.
go back to reference Huang YN, Gao S, Li SW, Huang Y, Li JF, Wong KS, Kay R: Vascular lesions in Chinese patients with transient ischemic attacks. Neurology. 1997, 48: 524-525.CrossRefPubMed Huang YN, Gao S, Li SW, Huang Y, Li JF, Wong KS, Kay R: Vascular lesions in Chinese patients with transient ischemic attacks. Neurology. 1997, 48: 524-525.CrossRefPubMed
6.
go back to reference Leung SY, Ng TH, Yuen ST, Lauder IJ, Ho FC: Pattern of cerebral atherosclerosis in Hong Kong Chinese. Severity in intracranial and extracranial vessels. Stroke. 1993, 24: 779-786. 10.1161/01.STR.24.6.779.CrossRefPubMed Leung SY, Ng TH, Yuen ST, Lauder IJ, Ho FC: Pattern of cerebral atherosclerosis in Hong Kong Chinese. Severity in intracranial and extracranial vessels. Stroke. 1993, 24: 779-786. 10.1161/01.STR.24.6.779.CrossRefPubMed
7.
go back to reference Gorelick PB, Wong KS, Bae HJ, Pandey DK: Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke. 2008, 39: 2396-2399. 10.1161/STROKEAHA.107.505776.CrossRefPubMed Gorelick PB, Wong KS, Bae HJ, Pandey DK: Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke. 2008, 39: 2396-2399. 10.1161/STROKEAHA.107.505776.CrossRefPubMed
8.
go back to reference Li H, Wong KS: Racial distribution of intracranial and extracranial atherosclerosis. Journal of Clinical Neuroscience. 2003, 10: 30-34. 10.1016/S0967-5868(02)00264-3.CrossRefPubMed Li H, Wong KS: Racial distribution of intracranial and extracranial atherosclerosis. Journal of Clinical Neuroscience. 2003, 10: 30-34. 10.1016/S0967-5868(02)00264-3.CrossRefPubMed
9.
go back to reference Lee B-C, Roh JK: International Experience in Stroke Registries: Korean Stroke Registry. American Journal of Preventive Medicine. 2006, 31: S243-S245. 10.1016/j.amepre.2006.08.019.CrossRefPubMed Lee B-C, Roh JK: International Experience in Stroke Registries: Korean Stroke Registry. American Journal of Preventive Medicine. 2006, 31: S243-S245. 10.1016/j.amepre.2006.08.019.CrossRefPubMed
10.
go back to reference Yu KH, Bae HJ, Kwon SU, Heo JH, Rha JH, Kim JS, Lee BC, Roh JK: Analysis of 10811 cases with acute ischemic stroke from Korean stroke registry: Hospital based multicenter prospective registration study. J Korean Neurol Assoc. 2006, 24: 535-543. Yu KH, Bae HJ, Kwon SU, Heo JH, Rha JH, Kim JS, Lee BC, Roh JK: Analysis of 10811 cases with acute ischemic stroke from Korean stroke registry: Hospital based multicenter prospective registration study. J Korean Neurol Assoc. 2006, 24: 535-543.
11.
go back to reference Thijs VN, Albers GW: Symptomatic intracranial atherosclerosis: Outcome of patients who fail antithrombotic therapy. Neurology. 2000, 55: 490-498.CrossRefPubMed Thijs VN, Albers GW: Symptomatic intracranial atherosclerosis: Outcome of patients who fail antithrombotic therapy. Neurology. 2000, 55: 490-498.CrossRefPubMed
12.
go back to reference Wityk RJ, Lehman D, Klag M, Coresh J, Ahn H, Litt B: Race and Sex Differences in the Distribution of Cerebral Atherosclerosis. Stroke. 1996, 27: 1974-1980. 10.1161/01.STR.27.11.1974.CrossRefPubMed Wityk RJ, Lehman D, Klag M, Coresh J, Ahn H, Litt B: Race and Sex Differences in the Distribution of Cerebral Atherosclerosis. Stroke. 1996, 27: 1974-1980. 10.1161/01.STR.27.11.1974.CrossRefPubMed
13.
go back to reference Sacco RL, Kargman DE, Gu Q, Zamanillo MC: Race-Ethnicity and Determinants of Intracranial Atherosclerotic Cerebral Infarction: The Northern Manhattan Stroke Study. Stroke. 1995, 26: 14-20. 10.1161/01.STR.26.1.14.CrossRefPubMed Sacco RL, Kargman DE, Gu Q, Zamanillo MC: Race-Ethnicity and Determinants of Intracranial Atherosclerotic Cerebral Infarction: The Northern Manhattan Stroke Study. Stroke. 1995, 26: 14-20. 10.1161/01.STR.26.1.14.CrossRefPubMed
14.
go back to reference Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC/IC Bypass Study Group. N Engl J Med. 1985, 313: 1191-1200. Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC/IC Bypass Study Group. N Engl J Med. 1985, 313: 1191-1200.
15.
go back to reference du Mesnil de Rochemont R, Turowski B, Buchkremer M, Sitzer M, Zanella FE, Berkefeld J: Recurrent Symptomatic High-Grade Intracranial Stenoses: Safety and Efficacy of Undersized Stents-- Initial Experience. Radiology. 2004, 231: 45-49. 10.1148/radiol.2311030183.CrossRef du Mesnil de Rochemont R, Turowski B, Buchkremer M, Sitzer M, Zanella FE, Berkefeld J: Recurrent Symptomatic High-Grade Intracranial Stenoses: Safety and Efficacy of Undersized Stents-- Initial Experience. Radiology. 2004, 231: 45-49. 10.1148/radiol.2311030183.CrossRef
16.
go back to reference Yoon W, Seo JJ, Cho KH, Kim MK, Kim BC, Park MS, Kim TS, Kim JK, Kang HK: Symptomatic Middle Cerebral Artery Stenosis Treated with Intracranial Angioplasty: Experience in 32 Patients. Radiology. 2005, 237: 620-626. 10.1148/radiol.2372041620.CrossRefPubMed Yoon W, Seo JJ, Cho KH, Kim MK, Kim BC, Park MS, Kim TS, Kim JK, Kang HK: Symptomatic Middle Cerebral Artery Stenosis Treated with Intracranial Angioplasty: Experience in 32 Patients. Radiology. 2005, 237: 620-626. 10.1148/radiol.2372041620.CrossRefPubMed
17.
go back to reference Kim JK, Ahn JY, Lee BH, Chung YS, Chung SS, Kim OJ, Kim WC, Joo JY: Elective stenting for symptomatic middle cerebral artery stenosis presenting as transient ischaemic deficits or stroke attacks: short term arteriographical and clinical outcome. J Neurol Neurosurg Psychiatry. 2004, 75: 847-851. 10.1136/jnnp.2003.019570.CrossRefPubMedPubMedCentral Kim JK, Ahn JY, Lee BH, Chung YS, Chung SS, Kim OJ, Kim WC, Joo JY: Elective stenting for symptomatic middle cerebral artery stenosis presenting as transient ischaemic deficits or stroke attacks: short term arteriographical and clinical outcome. J Neurol Neurosurg Psychiatry. 2004, 75: 847-851. 10.1136/jnnp.2003.019570.CrossRefPubMedPubMedCentral
18.
go back to reference Lee JH, Kwon SU, Lee JH, Suh DC, Kim JS: Percutaneous Transluminal Angioplasty for Symptomatic Middle Cerebral Artery Stenosis: Long-Term Follow-Up. Cerebrovasc Dis. 2003, 15: Lee JH, Kwon SU, Lee JH, Suh DC, Kim JS: Percutaneous Transluminal Angioplasty for Symptomatic Middle Cerebral Artery Stenosis: Long-Term Follow-Up. Cerebrovasc Dis. 2003, 15:
19.
go back to reference Connors JJ, W J: Percutaneous transluminal angioplasty for intracranial atherosclerotic lesions: evolution of technique and short-term results. J Neurosurg. 1999, 91: 415-423. 10.3171/jns.1999.91.3.0415.CrossRefPubMed Connors JJ, W J: Percutaneous transluminal angioplasty for intracranial atherosclerotic lesions: evolution of technique and short-term results. J Neurosurg. 1999, 91: 415-423. 10.3171/jns.1999.91.3.0415.CrossRefPubMed
20.
go back to reference Kasner SE, Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Benesch CG, et al: Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis. Circulation. 2006, 113: 555-563. 10.1161/CIRCULATIONAHA.105.578229.CrossRefPubMed Kasner SE, Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Benesch CG, et al: Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis. Circulation. 2006, 113: 555-563. 10.1161/CIRCULATIONAHA.105.578229.CrossRefPubMed
21.
go back to reference Corston RN, Kendall BE, Marshall J: Prognosis in middle cerebral artery stenosis. Stroke. 1984, 15: 237-241. 10.1161/01.STR.15.2.237.CrossRefPubMed Corston RN, Kendall BE, Marshall J: Prognosis in middle cerebral artery stenosis. Stroke. 1984, 15: 237-241. 10.1161/01.STR.15.2.237.CrossRefPubMed
22.
go back to reference Rorick MB, Nichols FT, Adams RJ: Transcranial Doppler correlation with angiography in detection of intracranial stenosis. Stroke. 1994, 25: 1931-1934. 10.1161/01.STR.25.10.1931.CrossRefPubMed Rorick MB, Nichols FT, Adams RJ: Transcranial Doppler correlation with angiography in detection of intracranial stenosis. Stroke. 1994, 25: 1931-1934. 10.1161/01.STR.25.10.1931.CrossRefPubMed
23.
go back to reference Caplan L, Babikian V, Helgason C, Hier DB, DeWitt D, Patel D, Stein R: Occlusive disease of the middle cerebral artery. Neurology. 1985, 35: 975-982.CrossRefPubMed Caplan L, Babikian V, Helgason C, Hier DB, DeWitt D, Patel D, Stein R: Occlusive disease of the middle cerebral artery. Neurology. 1985, 35: 975-982.CrossRefPubMed
24.
go back to reference Hinton RC, Mohr JP, Ackerman RH, Adair LB, Fisher CM: Symptomatic middle cerebral artery stenosis. Ann Neurol. 1979, 5: 152-157. 10.1002/ana.410050208.CrossRefPubMed Hinton RC, Mohr JP, Ackerman RH, Adair LB, Fisher CM: Symptomatic middle cerebral artery stenosis. Ann Neurol. 1979, 5: 152-157. 10.1002/ana.410050208.CrossRefPubMed
25.
go back to reference Tsai NW, Chang HW, Chang WN, Huang CR, Lin TK, Chen SD, Lui CC, Wang KW, Cheng BC, Hung PL, Chang CS, Lu CH: Prognostic factors and therapeutic outcome of isolated symptomatic middle cerebral artery stenosis. Eur J Neurol. 2005, 12: 519-526. 10.1111/j.1468-1331.2005.00995.x.CrossRefPubMed Tsai NW, Chang HW, Chang WN, Huang CR, Lin TK, Chen SD, Lui CC, Wang KW, Cheng BC, Hung PL, Chang CS, Lu CH: Prognostic factors and therapeutic outcome of isolated symptomatic middle cerebral artery stenosis. Eur J Neurol. 2005, 12: 519-526. 10.1111/j.1468-1331.2005.00995.x.CrossRefPubMed
26.
go back to reference Bogousslavsky J, Barnett HJ, Fox AJ, Hachinski VC, Taylor W: Atherosclerotic disease of the middle cerebral artery. Stroke. 1986, 17: 1112-1120. 10.1161/01.STR.17.6.1112.CrossRefPubMed Bogousslavsky J, Barnett HJ, Fox AJ, Hachinski VC, Taylor W: Atherosclerotic disease of the middle cerebral artery. Stroke. 1986, 17: 1112-1120. 10.1161/01.STR.17.6.1112.CrossRefPubMed
27.
go back to reference Arenillas JF, Molina CA, Montaner J, Abilleira S, Gonzalez SAM, Alvarez-Sabin J: Progression and Clinical Recurrence of Symptomatic Middle Cerebral Artery Stenosis: A Long-Term Follow-Up Transcranial Doppler Ultrasound Study. Stroke. 2001, 32: 2898-2904. 10.1161/hs1201.099652.CrossRefPubMed Arenillas JF, Molina CA, Montaner J, Abilleira S, Gonzalez SAM, Alvarez-Sabin J: Progression and Clinical Recurrence of Symptomatic Middle Cerebral Artery Stenosis: A Long-Term Follow-Up Transcranial Doppler Ultrasound Study. Stroke. 2001, 32: 2898-2904. 10.1161/hs1201.099652.CrossRefPubMed
28.
go back to reference Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Kasner SE, Benesch CG, et al: Comparison of Warfarin and Aspirin for Symptomatic Intracranial Arterial Stenosis. N Engl J Med. 2005, 352: 1305-1316. 10.1056/NEJMoa043033.CrossRefPubMed Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Kasner SE, Benesch CG, et al: Comparison of Warfarin and Aspirin for Symptomatic Intracranial Arterial Stenosis. N Engl J Med. 2005, 352: 1305-1316. 10.1056/NEJMoa043033.CrossRefPubMed
29.
go back to reference Kern R, Steinke W, Daffertshofer M, Prager R, Hennerici M: Stroke recurrences in patients with symptomatic vs asymptomatic middle cerebral artery disease. Neurology. 2005, 65: 859-864. 10.1212/01.wnl.0000175983.76110.59.CrossRefPubMed Kern R, Steinke W, Daffertshofer M, Prager R, Hennerici M: Stroke recurrences in patients with symptomatic vs asymptomatic middle cerebral artery disease. Neurology. 2005, 65: 859-864. 10.1212/01.wnl.0000175983.76110.59.CrossRefPubMed
30.
go back to reference Kang BS, Kwon HM, Ryu WS, Lee YS: Prognosis of symptomatic and asymptomatic middle cerebral artery occlusion. Cerebrovasc Dis. 2008, 26: 489-493. 10.1159/000155986.CrossRefPubMed Kang BS, Kwon HM, Ryu WS, Lee YS: Prognosis of symptomatic and asymptomatic middle cerebral artery occlusion. Cerebrovasc Dis. 2008, 26: 489-493. 10.1159/000155986.CrossRefPubMed
31.
go back to reference Chimowitz MI, Kokkinos J, Strong J, Brown MB, Levine SR, Silliman S, Pessin MS, Weichel E, Sila CA, Furlan AJ, et al: The Warfarin-Aspirin Symptomatic Intracranial Disease Study. Neurology. 1995, 45: 1488-1493.CrossRefPubMed Chimowitz MI, Kokkinos J, Strong J, Brown MB, Levine SR, Silliman S, Pessin MS, Weichel E, Sila CA, Furlan AJ, et al: The Warfarin-Aspirin Symptomatic Intracranial Disease Study. Neurology. 1995, 45: 1488-1493.CrossRefPubMed
32.
go back to reference Akins PT, Pilgram TK, Cross DT, Moran CJ: Natural History of Stenosis From Intracranial Atherosclerosis by Serial Angiography. Stroke. 1998, 29: 433-438. 10.1161/01.STR.29.2.433.CrossRefPubMed Akins PT, Pilgram TK, Cross DT, Moran CJ: Natural History of Stenosis From Intracranial Atherosclerosis by Serial Angiography. Stroke. 1998, 29: 433-438. 10.1161/01.STR.29.2.433.CrossRefPubMed
33.
go back to reference Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJM: Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. The Lancet. 2004, 363: 915-924. 10.1016/S0140-6736(04)15785-1.CrossRef Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJM: Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. The Lancet. 2004, 363: 915-924. 10.1016/S0140-6736(04)15785-1.CrossRef
34.
go back to reference Chimowitz MI, Lynn MJ, Derdeyn CP, Turan TN, Fiorella D, Lane BF, Janis LS, Lutsep HL, Barnwell SL, Waters MF, et al: Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis. New England Journal of Medicine. 2011, 365: 993-1003. 10.1056/NEJMoa1105335.CrossRefPubMedPubMedCentral Chimowitz MI, Lynn MJ, Derdeyn CP, Turan TN, Fiorella D, Lane BF, Janis LS, Lutsep HL, Barnwell SL, Waters MF, et al: Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis. New England Journal of Medicine. 2011, 365: 993-1003. 10.1056/NEJMoa1105335.CrossRefPubMedPubMedCentral
35.
go back to reference Kang S, Wu Y, Li X: Effects of statin therapy on the progression of carotid atherosclerosis: a systematic review and meta-analysis. Atherosclerosis. 2004, 177: 433-442. 10.1016/j.atherosclerosis.2004.08.005.CrossRefPubMed Kang S, Wu Y, Li X: Effects of statin therapy on the progression of carotid atherosclerosis: a systematic review and meta-analysis. Atherosclerosis. 2004, 177: 433-442. 10.1016/j.atherosclerosis.2004.08.005.CrossRefPubMed
36.
go back to reference Amarenco P, Bogousslavsky J, Callahan A, Goldstein LB, Hennerici M, Rudolph AE, Sillesen H, Simunovic L, Szarek M, Welch KM, Zivin JA, The Stroke Prevention by Aggressive Reduction in Cholesterol Levels, Investigators: High-Dose Atorvastatin after Stroke or Transient Ischemic Attack. N Engl J Med. 2006, 355: 549-559.CrossRefPubMed Amarenco P, Bogousslavsky J, Callahan A, Goldstein LB, Hennerici M, Rudolph AE, Sillesen H, Simunovic L, Szarek M, Welch KM, Zivin JA, The Stroke Prevention by Aggressive Reduction in Cholesterol Levels, Investigators: High-Dose Atorvastatin after Stroke or Transient Ischemic Attack. N Engl J Med. 2006, 355: 549-559.CrossRefPubMed
37.
go back to reference Chaturvedi S, Turan TN, Lynn MJ, Kasner SE, Romano J, Cotsonis G, Frankel M, Chimowitz MI: Risk factor status and vascular events in patients with symptomatic intracranial stenosis. Neurology. 2007, 69: 2063-2068. 10.1212/01.wnl.0000279338.18776.26.CrossRefPubMed Chaturvedi S, Turan TN, Lynn MJ, Kasner SE, Romano J, Cotsonis G, Frankel M, Chimowitz MI: Risk factor status and vascular events in patients with symptomatic intracranial stenosis. Neurology. 2007, 69: 2063-2068. 10.1212/01.wnl.0000279338.18776.26.CrossRefPubMed
38.
go back to reference Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. EUROASPIRE I and II Group. European Action on Secondary Prevention by Intervention to Reduce Events. Lancet. 2001, 357: 995-1001. 10.1016/S0140-6736(00)04235-5. Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. EUROASPIRE I and II Group. European Action on Secondary Prevention by Intervention to Reduce Events. Lancet. 2001, 357: 995-1001. 10.1016/S0140-6736(00)04235-5.
39.
go back to reference Ma R, Wang C, Zhao X, Xu M, Lv Y, Wei M, Cai Y, Zhang Z, Wang L, Zhang W, et al: A survey on compliance with secondary stroke prevention guidelines and follow up for the inpatients with atherosclerotic cerebral infarction/transient ischemic attack. Neurol Res. 2008, 30: 383-388. 10.1179/174313208X300404.CrossRefPubMed Ma R, Wang C, Zhao X, Xu M, Lv Y, Wei M, Cai Y, Zhang Z, Wang L, Zhang W, et al: A survey on compliance with secondary stroke prevention guidelines and follow up for the inpatients with atherosclerotic cerebral infarction/transient ischemic attack. Neurol Res. 2008, 30: 383-388. 10.1179/174313208X300404.CrossRefPubMed
40.
go back to reference Wong KS, Li H: Long-Term Mortality and Recurrent Stroke Risk Among Chinese Stroke Patients With Predominant Intracranial Atherosclerosis. Stroke. 2003, 34: 2361-2366. 10.1161/01.STR.0000089017.90037.7A.CrossRefPubMed Wong KS, Li H: Long-Term Mortality and Recurrent Stroke Risk Among Chinese Stroke Patients With Predominant Intracranial Atherosclerosis. Stroke. 2003, 34: 2361-2366. 10.1161/01.STR.0000089017.90037.7A.CrossRefPubMed
41.
go back to reference Wong KS, Li H, Lam WWM, Chan YL, Kay R: Progression of Middle Cerebral Artery Occlusive Disease and Its Relationship With Further Vascular Events After Stroke. Stroke. 2002, 33: 532-536. 10.1161/hs0202.102602.CrossRefPubMed Wong KS, Li H, Lam WWM, Chan YL, Kay R: Progression of Middle Cerebral Artery Occlusive Disease and Its Relationship With Further Vascular Events After Stroke. Stroke. 2002, 33: 532-536. 10.1161/hs0202.102602.CrossRefPubMed
Metadata
Title
Long-term prognosis of symptomatic isolated middle cerebral artery disease in Korean stroke patients
Authors
Mi Sun Oh
Kyung-Ho Yu
Min-Kyung Chu
Hyeo-Il Ma
Yun Joong Kim
Joo Yong Kim
Byung-Chul Lee
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2011
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-11-138

Other articles of this Issue 1/2011

BMC Neurology 1/2011 Go to the issue