Projects per year
Abstract
Background: Up to 20% of lacunar infarcts are clinically misdiagnosed as cortical infarcts and vice versa. The reasons for this discrepancy are unclear. We assessed clinical and imaging features which might explain this 'clinical-imaging dissociation' (C-ID). Methods: Patients with an acute stroke syndrome (cortical or lacunar) underwent magnetic resonance imaging including diffusion-weighted imaging (DWI). We recorded DWI-positive infarcts and proximity to cortex for small subcortical infarcts. We examined factors associated with C-ID. Results: 137 patients with a mild cortical or lacunar syndrome had an acute ischemic lesion on DWI. Of these, 21/93 (23%) with a cortical syndrome had an acute lacunar infarct and 7/44 (16%) with a lacunar syndrome had an acute cortical infarct. From 72 patients with an acute lacunar infarct on DWI, lesion proximity to cortex (odds ratio (OR) 14.5, 95% confidence interval (CI) 1.61-130.1), left hemisphere location (OR 8.95, 95% CI 1.23-64.99) and diabetes (OR 17.1, 95% CI 1.49-196.16) predicted C-ID. On multivariate analysis of all 137 patients, C-ID was associated with diabetes (OR 7.12, 95% CI 1.86-27.2). Conclusions: C-ID occurs in a fifth of patients with mild stroke. Lacunar infarcts lying close to cortex are more likely to cause cortical symptoms. Diabetes is associated with any clinical-imaging mismatch. Stroke misclassification which can arise with clinical classification alone should be minimized in research by verification with high-sensitivity imaging. Copyright (C) 2010 S. Karger AG, Basel
Original language | English |
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Pages (from-to) | 395-402 |
Number of pages | 8 |
Journal | Cerebrovascular diseases |
Volume | 29 |
Issue number | 4 |
DOIs | |
Publication status | Published - 2010 |
Keywords / Materials (for Non-textual outputs)
- Acute ischemic stroke
- Stroke subtype
- Infarction
- Acute stroke imaging
- Diffusion-weighted imaging
- DIFFUSION-WEIGHTED MRI
- COMPUTED-TOMOGRAPHY
- LACUNAR STROKE
- PROJECT CLASSIFICATION
- CEREBRAL INFARCTION
- MINOR STROKE
- SUBTYPES
- ABNORMALITIES
- BRAIN
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Dive into the research topics of 'Associations of Clinical Stroke Misclassification ('Clinical-Imaging Dissociation') in Acute Ischemic Stroke'. Together they form a unique fingerprint.Projects
- 4 Finished
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SINAPSE - sub budget - Edinburgh
UK central government bodies/local authorities, health and hospital authorities
1/12/09 → 31/12/14
Project: Research
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Can retinal vascular abnormalities shed light on the pathiophysioologyof lacunar strokes
25/04/05 → 24/07/08
Project: Research