Correlation Among Infarct Size, Location And Pathogenesis In Single Subcortical Infarctions

Objective:To study the correlation among infarct size, location and pathogenesis in Single Subcortical Infarctions (SSI).Methods:Patients of single subcortical infarction in the cerebral perforating artery territory within 1 week of stroke onset confirmed by diffusion weighted imaging (DWI) admitted between January 2008 and October 2014 at the Chinese PLA General hospital, Department of Neurology. All patients complete the magnetic resonance angiography (MRA) and cervical vascular ultrasound. We divided the SSI into 3 groups according to the size of lesions (diameter, D):D<1.5cm,1.5cm≤D≤2.0cm and D>2.0cm. We also divided the SSI into 2 groups according to the infarct region:Supratentorial region and Brain Stem. Finally, patients were divided into 2 groups according to the infarct location relative to its parent artery:Proximal infarction and Distal infarction. The risk factors and artery states were compared among the above groups. At last, we analyze the features of infarct location relative to its parent artery differ from the infarct size and region.Results:1. SSI with D>2.0cm had the high prevalence of parent artery stenosis and carotid atherosclerosis, whereas SSI with D< 2.0cm had the high prevalence of hypertension.2. In terms of the infarct region, hypertension, diabetes, hyperlipemia, parent artery stenosis, other intracranialaorta stenosis and carotid atherosclerosis are more prevalent in brain stem than supratentorial region.3. Owing to the difference in lesions’position to parent artery, characters differ from proximal infarction to distal infarction. Patients of proximal infarction are predisposed to parent artery stenosis, while the distal infarction patients are susceptible to hypertension.4. The lesions of SSI with D>2.0cm could either located in the proximal or in the distal to its parent artery, and the same is true for SSI with D<2.0cm. And the lesions of SSI in Supratentorial region could either located in the proximal or in the distal to its parent artery, and the same is true for SSI in Brain Stem.Conclusion:Risk factors and vascular states of SSI are various in distinct size and region, suggesting that heterogeneous pathogenesis are involved.