Etiology Of Penetrating Artery Territory Infarction And Characteristics Study

Objective: Using high-resolution magnetic resonance imaging(HR MRI)diagnosis of penetrating artery territory infarction,including Penetrating artery disease(PAD)and Parent artery plaque occluding penetrating(POPA),which belongs to the large-artery atherosclerosis,and compare their clinical features.Methods: Patients with acute Striate artery and Pontine paramedian artery territory infarction were included.According to the criteria of CISS classification,Cardiogenic stroke,other etiologies and undetermined etiology were excluded.The patients satisfied the criteria were examined by HR MRI to evaluate atherosclerosis of the Parent artery,Patients with atherosclerotic plaque in the parent arteries were defined as the POPA group,and those without abnormalities as the PAD.Results:1.64 patients with penetrating artery territory infarction were enrolled in this study,POPA was diagnosed in 48 patients,in them,21 patients whose MRA/TCD were normal,while HR MRI detected the parent arteries with plaques.2.Patients in POPA group had a higher frequency of smoking compared with patients in PAD group(P=0.028,<0.05).3.There were 26 patients in POPA group with Striate artery territory infarction and 22 patients with Pontine paramedian artery territory infarction.Compared with infarct lesions with PAD,ischemic lesions in POPA patients were relatively more larger,and shown as multifocal or cluster-like distribution and frequently extended to the surface of the pons base.And motor function deficits easily progress.While lesions with PAD were usually small lacunar infarctions,or located in the deep of pons.Conclusion:1.Our research shows most patients of the penetrating artery territory infarction belongs to Parent artery atherosclerosis,HR MRI has the ability to improve the accuracy of clearing the etiology of ischemic stroke.2.The risk factors,clinical characteristics and radiological features of POPA patients were different from PAD.