Coexisting causes of ischemic stroke.
Arch Neurol
; 57(8): 1139-44, 2000 Aug.
Article
em En
| MEDLINE
| ID: mdl-10927793
ABSTRACT
BACKGROUND:
Coexistence of multiple potential causes of cerebral infarct (MPCI) has been poorly studied.OBJECTIVE:
To determine the risk factors, clinical findings, and topographical patterns of patients with at least 2 potential causes of cerebral infarct.DESIGN:
Data analysis from a prospective acute stroke registry (the Lausanne Stroke Registry, Lausanne, Switzerland) in a community-based primary care center.RESULTS:
Among 3525 patients with first-ever ischemic stroke consecutively admitted to a primary care stroke center, 250 patients (7%) had at least 2 MPCIs, with the following subgroups large artery disease and a cardiac source of embolism (LAD + CSE) (43%), small artery disease and CSE (SAD + CSE) (34%), LAD + SAD (18%), and LAD + SAD + CSE (5%). Hypertension, cardiac ischemia, and a history of atrial fibrillation predominated in the LAD + SAD + CSE subgroup (P<.001), while cigarette smoking was more prevalent in the LAD + SAD subgroup (P<.05). A decreased level of consciousness and speech disorders were more common in the LAD + CSE subgroup (P<.001). Lacunar syndromes predominated in the LAD + SAD subgroup. Pure motor stroke was the most frequent lacunar syndrome in all subgroups, but sensory motor stroke predominated in the LAD + CSE subgroup (P<.05). The outcome at 1 month was worse in the LAD + CSE and SAD + CSE subgroups (P<.001). Other stroke characteristics and clinical features did not differ significantly between the 4 subgroups of patients with MPCI.CONCLUSIONS:
Our findings suggest that MPCIs are uncommon. The most frequent association is LAD + CSE. Topographical patterns of stroke and clinical characteristics in patients with MPCI only rarely allow emphasis of a preeminent cause. Arch Neurol. 2000;571139-1144
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Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
/
Acidente Vascular Cerebral
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2000
Tipo de documento:
Article